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Miranda RA, Lima DGV, de Souza LL, Souza da Silva B, Bertasso IM, Meyer LG, Rossetti CL, Junior RR, Miranda-Alves L, de Moura EG, Lisboa PC. Maternal exposure to tributyltin alters the breast milk, hormonal profile, and thyroid morphology of dams and induces sex-specific changes in neonate rat offspring. Environ Pollut 2024:123963. [PMID: 38621455 DOI: 10.1016/j.envpol.2024.123963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/22/2024] [Accepted: 04/10/2024] [Indexed: 04/17/2024]
Abstract
Tributyltin (TBT) is the chemical substance commonly used worldwide to prevent biofouling of vessels. Due to its ability to bioaccumulate and biomagnify, even after being banned, significant concentrations of TBT can be detected in sediment, affecting marine and human life. Although studies have shown that direct exposure to TBT alters physiological parameters in mammals, the relationship between exposure to TBT during pregnancy and lactation, considered critical windows for metabolic programming, has not been fully elucidated. Our hypothesis is that offspring whose mothers were exposed to TBT during critical stages of development may exhibit dysfunctions in endocrine-metabolic parameters. We used pregnant Wistar rats that were divided into groups and received the following treatments from gestational day 7 until the end of lactation by intragastric gavage: vehicle (ethanol 0.01%; Control), low TBT dose (100 ng/kg of body weight (bw)/day; TBT100ng) and high TBT dose (1000 ng/kg bw/day; TBT1000ng). Dams and offspring at birth and weaning (21 days old) were studied. Maternal exposure to TBT promoted dose-dependent changes in dams. The findings for adiposity, milk composition and lipid profile were more pronounced in TBT100ng dams; however, thyroid morphology was altered in TBT1000ng dams. Female offspring were differentially affected by the dose of exposure. At birth, females in the TBT100ng group had low body weight, lower naso-anal length (NAL), and higher plasma T4, and at weaning, females in the TBT100ng group had lower insulin and leptin levels. Females in the TBT1000ng group had lower NAL at birth and lower leptinemia and weight of white adipose tissue at weaning. Male offspring from TBT groups showed high T3 at birth, without biometric alterations at birth or weaning. Despite these findings, both sexes exhibited dose-dependent morphological changes in the thyroid gland. Thus, maternal exposure to TBT constitutes an important route of contamination for both dams and offspring.
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Affiliation(s)
- Rosiane Aparecida Miranda
- Laboratory of Endocrine Physiology, Institute of Biology Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, RJ, Brazil
| | - Daniel Galinis Vieira Lima
- Laboratory of Endocrine Physiology, Institute of Biology Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, RJ, Brazil
| | - Luana Lopes de Souza
- Laboratory of Endocrine Physiology, Institute of Biology Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, RJ, Brazil
| | - Beatriz Souza da Silva
- Laboratory of Endocrine Physiology, Institute of Biology Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, RJ, Brazil
| | - Iala Milene Bertasso
- Laboratory of Endocrine Physiology, Institute of Biology Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, RJ, Brazil
| | - Lilian Guedes Meyer
- Laboratory of Endocrine Physiology, Institute of Biology Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, RJ, Brazil
| | - Camila Lüdke Rossetti
- Laboratory of Endocrine Physiology, Institute of Biology Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, RJ, Brazil
| | - Reinaldo Röpke Junior
- Laboratory of Experimental Endocrinology, Institute of Biomedical Sciences, Universidade Federal do Rio de Janeiro, RJ, Brazil
| | - Leandro Miranda-Alves
- Laboratory of Experimental Endocrinology, Institute of Biomedical Sciences, Universidade Federal do Rio de Janeiro, RJ, Brazil
| | - Egberto Gaspar de Moura
- Laboratory of Endocrine Physiology, Institute of Biology Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, RJ, Brazil
| | - Patricia Cristina Lisboa
- Laboratory of Endocrine Physiology, Institute of Biology Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, RJ, Brazil;.
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Salemi TF, McLean VR, Jnah AJ. Congenital and Postnatal Cytomegalovirus: Case Series and State of the Science for Neonatal Providers. Neonatal Netw 2024; 43:92-104. [PMID: 38599771 DOI: 10.1891/nn-2023-0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
Cytomegalovirus (CMV), a beta-herpes virus, is the most common viral infection in infants. Transmission may occur congenitally (cCMV) or postnatally (pCMV). Early detection and intervention are crucial in reducing morbidities, notable developmental delays, and sensorineural hearing loss. However, more than 90% of infants are asymptomatic at birth. Treatment involves intravenous ganciclovir or the oral prodrug, valganciclovir, drugs usually reserved for use with symptomatic infants because of the toxicity profile. Research currently supports standardized antenatal CMV screening and treatment of affected pregnant patients with hyperimmune globulin as well as vaccination against CMV in unaffected pregnant patients, although widespread adoption is lacking. Standardized postnatal CMV screening is a proven, cost-effective way to detect and diagnose CMV and optimize outcomes across the lifespan. This article presents a case series of cCMV and pCMV and a review of the state of science of CMV as well as promising scientific advances that are on the horizon.
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Alcaraz MR, Espinosa-Mansilla A, Durán-Merás I, Muñoz de la Peña A. An optimized methodology for the determination of multiclass organic ultraviolet sunscreens and metabolites in human milk through chromatographic and chemometric resolution. Talanta 2024; 270:125560. [PMID: 38128275 DOI: 10.1016/j.talanta.2023.125560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023]
Abstract
Organic UV filters (UVFS) are used to mitigate the dermal effects associated with health risks from UV radiation, making them essential in personal care products. UVFS are frequently identified in environmental samples due to their high lipophilicity and persistence, underscoring the urgency of comprehensive assessments and regulatory measures aimed at safeguarding ecosystems and human health. The present study reports a multiclass analytical method for determining 16 UV sunscreens and metabolites in breast milk based on an ultrasound-assisted-dispersive liquid-liquid micro-extraction (UA-DLLME) with further chromatographic and chemometric resolution. The experimental conditions of the UA-DLLME were optimized through the implementation of the Design of Experiment tools. To model the responses, least-squares and artificial neural network methodologies were implemented. The optimal conditions were found by employing the desirability function. The samples were analyzed through reverse-phase liquid chromatographic separation, UV diode array, and fast-scanning fluorescence detection. The chromatographic analysis enabled the resolution of 16 analytes in a total time of 13.0 min. Multivariate curve resolution-alternating least-square (MCR-ALS) modelling was implemented to resolve analytes that were not fully resolved and to determine analytes that coeluted with endogenous components of the breast milk samples. An enrichment factor of 5-fold concentration was obtained with this methodology, reaching recoveries between 65 % and 105 % for 13 multiclass UV sunscreens and metabolites in breast milk samples with RSD % and REP % lower than 12 %.
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Affiliation(s)
- Mirta R Alcaraz
- Laboratorio de Desarrollo Analítico y Quimiometría (LADAQ), Cátedra de Química Analítica I, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Ciudad Universitaria, Santa Fe, S3000ZAA, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Godoy Cruz 2290 CABA, C1425FQB, Argentina; Departamento de Química Analítica, Universidad de Extremadura, Badajoz, 06006, Spain.
| | | | - Isabel Durán-Merás
- Departamento de Química Analítica, Universidad de Extremadura, Badajoz, 06006, Spain
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Thayagabalu S, Cacho N, Sullivan S, Smulian J, Louis‐Jacques A, Bourgeois M, Chen H, Weerasuriya W, Lemas DJ. A systematic review of contaminants in donor human milk. Matern Child Nutr 2024; 20:e13627. [PMID: 38268226 PMCID: PMC10981490 DOI: 10.1111/mcn.13627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/26/2024]
Abstract
Donor human milk (DHM) from a milk bank is the recommended feeding method for preterm infants when the mother's own milk (MOM) is not available. Despite this recommendation, information on the possible contamination of donor human milk and its impact on infant health outcomes is poorly characterised. The aim of this systematic review is to assess contaminants present in DHM samples that preterm and critically ill infants consume. The data sources used include PubMed, EMBASE, CINAHL and Web of Science. A search of the data sources targeting DHM and its potential contaminants yielded 426 publications. Two reviewers (S. T. and D. L.) conducted title/abstract screening through Covidence software, and predetermined inclusion/exclusion criteria yielded 26 manuscripts. Contaminant types (bacterial, chemical, fungal, viral) and study details (e.g., type of bacteria identified, study setting) were extracted from each included study during full-text review. Primary contaminants in donor human milk included bacterial species and environmental pollutants. We found that bacterial contaminants were identified in 100% of the papers in which bacterial contamination was sought (16 papers) and 61.5% of the full data set (26 papers), with the most frequently identified genera being Staphylococcus (e.g., Staphylococcus aureus and coagulase-negative Staphylococcus) and Bacillus (e.g., Bacillus cereus). Chemical pollutants were discovered in 100% of the papers in which chemical contamination was sought (eight papers) and 30.8% of the full data set (26 papers). The most frequently identified chemical pollutants included perfluoroalkyl substances (six papers), toxic metal (one paper) and caffeine (one paper). Viral and fungal contamination were identified in one paper each. Our results highlight the importance of establishing standardisation in assessing DHM contamination and future studies are needed to clarify the impact of DHM contaminants on health outcomes.
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Affiliation(s)
- Sionika Thayagabalu
- Department of Health Outcomes and Biomedical Informatics, College of MedicineUniversity of FloridaGainesvilleFloridaUSA
| | - Nicole Cacho
- Department of Pediatrics, Division of NeonatologyUniversity of CaliforniaDavisCaliforniaUSA
| | - Sandra Sullivan
- Envision Healthcare, HCA Florida North Florida HospitalGainesvilleFloridaUSA
| | - John Smulian
- Department of Obstetrics and Gynecology, College of MedicineUniversity of FloridaGainesvilleFloridaUSA
- Center for Perinatal Outcomes Research, College of MedicineUniversity of FloridaGainesvilleFloridaUSA
| | - Adetola Louis‐Jacques
- Department of Obstetrics and Gynecology, College of MedicineUniversity of FloridaGainesvilleFloridaUSA
- Center for Perinatal Outcomes Research, College of MedicineUniversity of FloridaGainesvilleFloridaUSA
| | - Marie Bourgeois
- Department of Public HealthUniversity of South FloridaTampaFloridaUSA
| | - Henian Chen
- Department of Public HealthUniversity of South FloridaTampaFloridaUSA
| | | | - Dominick J. Lemas
- Department of Health Outcomes and Biomedical Informatics, College of MedicineUniversity of FloridaGainesvilleFloridaUSA
- Department of Obstetrics and Gynecology, College of MedicineUniversity of FloridaGainesvilleFloridaUSA
- Center for Perinatal Outcomes Research, College of MedicineUniversity of FloridaGainesvilleFloridaUSA
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Baker T, Lorch U, Bagger Y, Holmqvist C, Jonker DM, Urban LE, Hale TW. No Measurable Transfer of Oxytocin-Receptor Agonist Merotocin Detected in Human Breast Milk. Breastfeed Med 2024. [PMID: 38529915 DOI: 10.1089/bfm.2024.0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Objective: The study aimed to assess the transfer of merotocin from systemic circulation to breast milk in early postpartum women and women with established lactation. Methods: This was a two-part, multicenter, open-label, parallel-group study. Merotocin was administered as a single 90-minute intravenous (iv) infusion mimicking the intranasal pharmacokinetic profile. In Part A, 12 early postpartum women received doses of either 4 μg (n = 6) or 16 μg (n = 6) of merotocin within 4 days of delivery. In Part B, six women with established lactation received 20 μg of merotocin. The total concentration of merotocin in plasma and breast milk and its metabolites excreted in breast milk were measured at various time points. Adverse events (AEs) were also assessed for both parts of the study. Results: In both early postpartum and established lactation groups (mean age, 26.3 years; 83.3% Caucasian), merotocin and its metabolites in breast milk were below the limit of quantification (25.0 pg/mL) at all time points. Sixteen treatment-emergent AEs occurred in early postpartum women only, including seven events of uterine spasm and three of breast engorgement. There was one moderate event, whereas all the other events were considered mild. Conclusion: Merotocin was undetectable in breast milk after single iv administration of up to 20 μg in early postpartum women and women with established lactation.
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Affiliation(s)
- Teresa Baker
- Texas Tech University Health Sciences Center School of Medicine, Amarillo, Texas, USA
| | | | - Yu Bagger
- Ferring Pharmaceuticals, A/S, Copenhagen, Denmark
| | | | | | - Lorien E Urban
- Ferring Pharmaceuticals, Inc., Parsippany, New Jersey, USA
| | - Thomas W Hale
- Texas Tech University Health Sciences Center School of Medicine, Amarillo, Texas, USA
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Suteerojntrakool O, Mekangkul E, Maitreechit D, Khabuan S, Sodsai P, Hirankarn N, Thumbovorn R, Chomtho S. Preservation of Anti-SARS-CoV-2 Neutralizing Antibodies in Breast Milk: Impact of Maternal COVID-19 Vaccination and Infection. Breastfeed Med 2024. [PMID: 38506333 DOI: 10.1089/bfm.2023.0323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Objectives: To investigate specific immunoglobulin A (sIgA), specific immunoglobulin G (sIgG), and neutralizing antibodies (NAbs) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in breast milk and compare immunity in mothers with hybrid immunity (infection and vaccination) versus those solely vaccinated (coronavirus disease [COVID]-naïve). Methods: A longitudinal study was conducted among lactating mothers who received at least two doses of the coronavirus disease 2019 (COVID-19) vaccine or tested positive for SARS-CoV-2. Details of vaccination and infection were collected through questionnaires and interviews. Fifteen milliliters of breast milk samples, self-collected at 1, 3, and 6 months postvaccination or infection, were sent to analysis for sIgA, sIgG, and NAbs using enzyme-linked immunosorbent assay. Results: In total, 119 lactating mothers (202 milk samples) were enrolled; 82 participants had hybrid immunity, and 32 were COVID-19-naïve. Two-thirds received a combination of different vaccines and booster shots. Breast milk retained sIgA, sIgG, and NAbs for up to 6 months post-COVID vaccination or infection. At 3 months, mothers with hybrid immunity had significantly higher sIgA and NAbs compared with COVID-naïve mothers (geometric mean [95% confidence interval (CI)] of sIgA 2.72 [1.94-3.8] vs. 1.44 [0.83-2.48]; NAbs 86.83 [84.9-88.8] vs. 81.28 [76.02-86.9]). No differences in sIgA, sIgG, and NAbs were observed between lactating mothers receiving two, three, or more than or equal to three doses, regardless of hybrid immunity or COVID-naïve status. Conclusion: sIgA, sIgG, and NAbs against SARS-CoV-2 in breast milk sustained for up to 6 months postimmunization and infection. Higher immunity was found in mothers with hybrid immunity. These transferred immunities confirm in vitro protection, supporting the safety of breastfeeding during and after COVID-19 vaccination or infection.
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Affiliation(s)
- Orapa Suteerojntrakool
- Pediatric Nutrition Research Unit, Division of Nutrition, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Ambulatory Division, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Eakkarin Mekangkul
- Pediatric Nutrition Research Unit, Division of Nutrition, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Division of Nutrition, Department of Pediatrics, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
| | | | - Siriporn Khabuan
- Pediatric Nutrition Research Unit, Division of Nutrition, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Pimpayao Sodsai
- Center of Excellence in Immunology and Immune-Mediated Diseases, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nattiya Hirankarn
- Center of Excellence in Immunology and Immune-Mediated Diseases, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Rungtip Thumbovorn
- Department of Microbiology, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
| | - Sirinuch Chomtho
- Pediatric Nutrition Research Unit, Division of Nutrition, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Zheng S, Wang J, Luo K, Gu X, Yuan G, Wei M, Yao Y, Zhao Y, Dai J, Zhang K. Comprehensive Characterization of Organic Light-Emitting Materials in Breast Milk by Target and Suspect Screening. Environ Sci Technol 2024; 58:5103-5116. [PMID: 38445973 DOI: 10.1021/acs.est.3c08961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
Organic light-emitting materials (OLEMs) are emerging contaminants in the environment and have been detected in various environment samples. However, limited information is available regarding their contamination within the human body. Here, we developed a novel QuEChERS (quick, easy, cheap, effective, rugged, and safe) method coupled with triple quadrupole/high-resolution mass spectrometry to determine OLEMs in breast milk samples, employing both target and suspect screening strategies. Our analysis uncovered the presence of seven out of the 39 targeted OLEMs in breast milk samples, comprising five liquid crystal monomers and two OLEMs commonly used in organic light-emitting diode displays. The cumulative concentrations of the seven OLEMs in each breast milk sample ranged from ND to 1.67 × 103 ng/g lipid weight, with a mean and median concentration of 78.76 and 0.71 ng/g lipid weight, respectively, which were higher compared to that of typical organic pollutants such as polychlorinated biphenyls and polybrominated diphenyl ethers. We calculated the estimated daily intake (EDI) rates of OLEMs for infants aged 0-12 months, and the mean EDI rates during lactation were estimated to range from 30.37 to 54.89 ng/kg bw/day. Employing a suspect screening approach, we additionally identified 66 potential OLEMs, and two of them, cholesteryl hydrogen phthalate and cholesteryl benzoate, were further confirmed using pure reference standards. These two substances belong to cholesteric liquid crystal materials and raise concerns about potential endocrine-disrupting effects, as indicated by in silico predictive models. Overall, our present study established a robust method for the identification of OLEMs in breast milk samples, shedding light on their presence in the human body. These findings indicate human exposure to OLEMs that should be further investigated, including their health risks.
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Affiliation(s)
- Shuping Zheng
- State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, School of Environmental Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
| | - Jingsheng Wang
- State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, School of Environmental Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
| | - Kai Luo
- Key Laboratory of Environment Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
| | - Xiaoxia Gu
- Zhongda Hospital, Southeast University, Nanjing 210009, China
| | - Guanxiang Yuan
- Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China
| | - Meiting Wei
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, Guangdong, China
| | - Yao Yao
- The Genetics Laboratory, Longgang District Maternity & Child Healthcare Hospital of Shenzhen City, Longgang Maternity and Child Institute, Shantou University Medical College, Shenzhen 518172, Guangdong, China
| | - Yanbin Zhao
- State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, School of Environmental Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
- Shanghai Institute of Pollution Control and Ecological Security, Shanghai 200092, China
| | - Jiayin Dai
- State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, School of Environmental Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
| | - Kun Zhang
- State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, School of Environmental Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
- Shanghai Institute of Pollution Control and Ecological Security, Shanghai 200092, China
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Miao Y, Zheng Y, Wang T, Yi W, Zhang N, Zhang W, Zheng Z. Breast milk transmission and involvement of mammary glands in tick-borne flavivirus infected mice. J Virol 2024; 98:e0170923. [PMID: 38305156 PMCID: PMC10949448 DOI: 10.1128/jvi.01709-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/11/2024] [Indexed: 02/03/2024] Open
Abstract
Tick-borne flaviviruses (TBFs) are transmitted to humans through milk and tick bites. Although a case of possible mother-to-child transmission of tick-borne encephalitis virus (TBEV) through breast milk has been reported, this route has not been confirmed in experimental models. Therefore, in this study, using type I interferon receptor-deficient A129 mice infected with Langat virus (LGTV), we aimed to demonstrate the presence of infectious virus in the milk and mammary glands of infected mice. Our results showed viral RNA of LGTV in the pup's stomach milk clots (SMCs) and blood, indicating that the virus can be transmitted from dam to pup through breast milk. In addition, we observed that LGTV infection causes tissue lesions in the mammary gland, and viral particles were present in mammary gland epithelial cells. Furthermore, we found that milk from infected mice could infect adult mice via the intragastric route, which has a milder infection process, longer infection time, and a lower rate of weight loss than other modes of infection. Specifically, we developed a nano-luciferase-LGTV reporter virus system to monitor the dynamics of different infection routes and observed dam-to-pup infection using in vivo bioluminescence imaging. This study provides comprehensive evidence to support breast milk transmission of TBF in mice and has helped provide useful data for studying TBF transmission routes.IMPORTANCETo date, no experimental models have confirmed mother-to-child transmission of tick-borne flavivirus (TBF) through breastfeeding. In this study, we used a mouse model to demonstrate the presence of infectious viruses in mouse breast milk and mammary gland epithelial cells. Our results showed that pups could become infected through the gastrointestinal route by suckling milk, and the infection dynamics could be monitored using a reporter virus system during breastfeeding in vivo. We believe our findings have provided substantial evidence to understand the underlying mechanism of breast milk transmission of TBF in mice, which has important implications for understanding and preventing TBF transmission in humans.
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Affiliation(s)
- Yuanjiu Miao
- Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Yue Zheng
- Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Ting Wang
- Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei, China
- The Center for Biomedical Research, Department of Respiratory and Critical Care Medicine, National Health Commission (NHC) Key Laboratory of Respiratory Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenfu Yi
- Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Nailou Zhang
- Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei, China
| | - Wanpo Zhang
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Zhenhua Zheng
- Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei, China
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9
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Scoten O, Tabi K, Paquette V, Carrion P, Ryan D, Radonjic NV, Whitham EA, Hippman C. Attention-Deficit / Hyperactivity Disorder in pregnancy and the postpartum period. Am J Obstet Gynecol 2024:S0002-9378(24)00376-4. [PMID: 38432409 DOI: 10.1016/j.ajog.2024.02.297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/10/2024] [Accepted: 02/26/2024] [Indexed: 03/05/2024]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a childhood-onset neurodevelopmental disorder that frequently persists into adulthood, with 3% of adult women having a diagnosis of ADHD. Many women are diagnosed and treated during their reproductive years, resulting in management implications across pregnancy and postpartum. We know from clinical practice that ADHD symptoms frequently become challenging to manage during the perinatal period, requiring additional support and attention. There is often uncertainty among healthcare providers regarding the management of ADHD in the perinatal period, particularly the safety of pharmacotherapy for the developing fetus. This guideline is focused on best practices in managing ADHD in the perinatal period. We recommend: 1) mitigation of risks associated with ADHD worsening during the perinatal period via individualized treatment planning; 2) delivery of psychoeducation, self-management strategies/coaching, and psychotherapies; and, for those with moderate/severe ADHD, 3) consideration of ADHD pharmacotherapy, which has largely reassuring safety data. Specifically, providers should work collaboratively with patients and their support networks to balance the risks of perinatal ADHD medication with the risks of inadequately treated ADHD in pregnancy. The risks and impacts of ADHD in pregnancy can be successfully managed through preconception counselling and appropriate perinatal planning, management, and support.
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Affiliation(s)
- Olivia Scoten
- University of British Columbia (UBC), Vancouver, BC, Canada
| | - Katarina Tabi
- University of British Columbia (UBC), Vancouver, BC, Canada; Reproductive Mental Health Program, BC Women's Hospital, Vancouver, BC, Canada; BCCH Centre for Mindfulness, BC Children's Hospital, Vancouver, BC, Canada; BC Women's Health Research Institute, Vancouver, BC, Canada
| | | | - Prescilla Carrion
- University of British Columbia (UBC), Vancouver, BC, Canada; Reproductive Mental Health Program, BC Women's Hospital, Vancouver, BC, Canada
| | - Deirdre Ryan
- University of British Columbia (UBC), Vancouver, BC, Canada; Reproductive Mental Health Program, BC Women's Hospital, Vancouver, BC, Canada
| | - Nevena V Radonjic
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA
| | | | - Catriona Hippman
- University of British Columbia (UBC), Vancouver, BC, Canada; Reproductive Mental Health Program, BC Women's Hospital, Vancouver, BC, Canada; BC Women's Health Research Institute, Vancouver, BC, Canada; University of Calgary, Calgary, AB, Canada.
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10
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Wang F, Yu L, Ren Y, Zhang Q, He S, Zhao M, He Z, Gao Q, Chen J. An optimized culturomics strategy for isolation of human milk microbiota. Front Microbiol 2024; 15:1272062. [PMID: 38495514 PMCID: PMC10940525 DOI: 10.3389/fmicb.2024.1272062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 02/05/2024] [Indexed: 03/19/2024] Open
Abstract
Viable microorganisms and a diverse microbial ecosystem found in human milk play a crucial role in promoting healthy immune system and shaping the microbial community in the infant's gut. Culturomics is a method to obtain a comprehensive repertoire of human milk microbiota. However, culturomics is an onerous procedure, and needs expertise, making it difficult to be widely implemented. Currently, there is no efficient and feasible culturomics method specifically designed for human milk microbiota yet. Therefore, the aim of this study was to develop a more efficient and feasible culturomics method specifically designed for human milk microbiota. We obtained fresh samples of human milk from healthy Chinese mothers and conducted a 27-day enrichment process using blood culture bottles. Bacterial isolates were harvested at different time intervals and cultured on four different types of media. Using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) analysis, we identified a total of 6601 colonies and successfully obtained 865 strains, representing 4 phyla, 21 genera, and 54 species. By combining CBA and MRS media, we were able to cultivate over 94.4% of bacterial species with high diversity, including species-specific microorganisms. Prolonged pre-incubation in blood culture bottles significantly increased the number of bacterial species by about 33% and improved the isolation efficiency of beneficial bacteria with low abundance in human milk. After optimization, we reduced the pre-incubation time in blood culture bottles and selected optimal picking time-points (0, 3, and 6 days) at 37°C. By testing 6601 colonies using MALDI-TOF MS, we estimated that this new protocol could obtain more than 90% of bacterial species, reducing the workload by 57.0%. In conclusion, our new culturomics strategy, which involves the combination of CBA and MRS media, extended pre-incubation enrichment, and optimized picking time-points, is a feasible method for studying the human milk microbiota. This protocol significantly improves the efficiency of culturomics and allows for the establishment of a comprehensive repertoire of bacterial species and strains in human milk.
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Affiliation(s)
- Fan Wang
- Beijing YuGen Pharmaceutical Co., Ltd., Beijing, China
| | - Lingmin Yu
- YingTan City people’s Hospital, Yingtan, China
| | - Yuting Ren
- Beijing YuGen Pharmaceutical Co., Ltd., Beijing, China
| | - Qianwen Zhang
- Beijing YuGen Pharmaceutical Co., Ltd., Beijing, China
| | - Shanshan He
- Beijing YuGen Pharmaceutical Co., Ltd., Beijing, China
| | - Minlei Zhao
- Beijing YuGen Pharmaceutical Co., Ltd., Beijing, China
| | - Zhili He
- Beijing YuGen Pharmaceutical Co., Ltd., Beijing, China
| | - Qi Gao
- Beijing Hotgen Biotechnology Inc., Beijing, China
| | - Jianguo Chen
- Beijing YuGen Pharmaceutical Co., Ltd., Beijing, China
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Wu M, Xun Y, Dong H, Han S, Huang H, Xue Y, Zhang J, Yu W, Wang S, Ning Y, Yuan Q. The Concentration of Lactoferrin in Breast Milk Correlates with Maternal Body Mass Index and Parity. Breastfeed Med 2024; 19:208-216. [PMID: 38489527 DOI: 10.1089/bfm.2023.0215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
Background: Lactoferrin (LF) is a multifunctional glycoprotein found in human milk and body fluids, which has been shown to play a vital role in regulating the immunity and supporting the intestinal health of infants. Aim: This study evaluated the association between maternal/parturient factors and LF concentration in the breast milk of Chinese mothers. Methods: 207 breast milk samples were collected from healthy mothers with in the first year of lactation. Maternal and parturient information was collected for these participants through questionnaires. The content of lactoferrin in breast milk was detected by liquid chromatography, and macronutrient concentration in breast milk was measured by human milk analyzer in only 109 samples. Results: Our findings demonstrated that the LF content was much higher within the first month of lactation than it was after that period (p < 0.05). When compared with normal and lean mothers, the LF content of obese mothers was considerably higher (p < 0.05). The parity and LF content showed a favorable correlation. The proportion of LF to total protein tended to decrease as lactation progressed. Protein, fat, dry matter, and energy content were significantly positively correlated with LF content (p < 0.001). Conclusion: Early breast milk tends to have a higher level of LF, and the change of LF concentration in breast milk is associated with the parity and body mass index of the mother.
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Affiliation(s)
- Mingyue Wu
- Junlebao Dairy Group Co., Ltd., Shijiazhuang, China
| | - Yiping Xun
- Junlebao Dairy Group Co., Ltd., Shijiazhuang, China
| | - Huanzhe Dong
- Junlebao Dairy Group Co., Ltd., Shijiazhuang, China
| | - Sufang Han
- College of Food and Biology, Hebei University of Science and Technology, Shijiazhuang, China
| | | | - Yuling Xue
- Junlebao Dairy Group Co., Ltd., Shijiazhuang, China
| | - Jing Zhang
- Junlebao Dairy Group Co., Ltd., Shijiazhuang, China
| | - Wenhua Yu
- Junlebao Dairy Group Co., Ltd., Shijiazhuang, China
| | - Shijie Wang
- Junlebao Dairy Group Co., Ltd., Shijiazhuang, China
- College of Food and Biology, Hebei University of Science and Technology, Shijiazhuang, China
| | - Yibing Ning
- Junlebao Dairy Group Co., Ltd., Shijiazhuang, China
| | - Qingbin Yuan
- Junlebao Dairy Group Co., Ltd., Shijiazhuang, China
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Huang Y, Nyangau EM, Vyas NB, Joseph D, Laviolette LS, Tucker KN, Enderle JL. The Practicality of Preparing Skim Breast Milk at Home for Treatment of Infants Requiring Low Fat Diets. Breastfeed Med 2024; 19:217-222. [PMID: 38489530 DOI: 10.1089/bfm.2023.0299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
Introduction: The benefits of breast milk (BM) for infants have long been established. However, for health-compromised infants with difficulty processing long-chain triglycerides, BM is often discontinued, and skimmed breast milk (SBM) is used as a dietary treatment. SBM is usually produced for inpatients in a hospital laboratory. The aim of this study was to determine the viability of skimming BM at home. Case Report: A female infant was diagnosed with congenital lipomatous asymmetric overgrowth, vascular malformations, epidermal nevi, and skeletal and spinal anomalies (CLOVES) syndrome, with symptoms of lymphatic malformation, chylothorax, and pleural effusion. The patient's family produced SBM at home after discharge; the SBM met the dietary treatment requirements and kept symptoms under control. Methods: A nonrefrigerated benchtop centrifuge was used to produce SBM at the patient's home. The optimal setting for the centrifuge was determined and then used to process BM samples from the infant's mother. The samples were randomly selected from each 10-day period over 6 months, and 18 samples were processed in total. The hospital laboratory processed the same samples of BM and analyzed the macronutrients with a comparison of the home-produced SBM to the hospital-produced SBM. Results: The home-produced SBM met the dietary treatment requirement of <1.0 g/dL of fat content. Fat was significantly lower, proteins were significantly higher, and carbohydrates and calories were not significantly different compared to hospital-produced SBM. Conclusions: It is viable to consistently produce SBM at home that meets the dietary treatment requirements of health-compromised infants.
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Affiliation(s)
- Yuan Huang
- Department of Clinical Laboratory Sciences, School of Health Professions, University of Texas Medical Branch, Galveston, Texas, USA
| | - Emmanuel M Nyangau
- Department of Clinical Laboratory Sciences, School of Health Professions, University of Texas Medical Branch, Galveston, Texas, USA
| | - Niti B Vyas
- Department of Clinical Laboratory Sciences, School of Health Professions, University of Texas Medical Branch, Galveston, Texas, USA
| | - Deepa Joseph
- Milk Bank (Lab) Services, Texas Children's Hospital, Houston, Texas, USA
| | | | - Kristina N Tucker
- Milk Bank (Lab) Services, Texas Children's Hospital, Houston, Texas, USA
| | - Janet L Enderle
- Department of Clinical Laboratory Sciences, School of Health Professions, University of Texas Medical Branch, Galveston, Texas, USA
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Nixarlidou E, Margioula-Siarkou C, Almperis A, Vavoulidis E, Laganà AS, Dinas K, Petousis S. Clinical significance and main parameters promoting the breast‑feeding strategy (Review). Med Int (Lond) 2024; 4:14. [PMID: 38410759 PMCID: PMC10895466 DOI: 10.3892/mi.2024.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 02/02/2024] [Indexed: 02/28/2024]
Abstract
Breastfeeding provides numerous nutritional and immunological benefits, promotes neurological and cognitive development, and protects against chronic and infectious diseases, rendering it beneficial to the survival and well-being of infants. According to international recommendations, infants should be exclusively breastfed for the first 6 months. However, despite global health recommendations and funding initiatives, exclusive breastfeeding rates remain low worldwide. A number of studies attribute the low rates to factors that can be grouped into demographic, psychosocial, economic and midwifery factors, and outline the profile of each mother who opts to exclusively breastfeed her infant. In addition, the number of previous pregnancies, induced labor, the use of epidurals at birth or the possibility of the newborn being delivered prematurely, and the need for admission to an intensive care unit are the factors that reduce the likelihood of exclusive breastfeeding. Further research is required to understand the factors influencing the initiation and maintenance of exclusive breastfeeding, as international interventions have been ineffective. The aim of the present review was to provide an up-to-date summary of these various factors in an aim to assist health care professionals and policy makers in developing effective interventions with which to promote and support exclusive breastfeeding.
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Affiliation(s)
- Eleni Nixarlidou
- 2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, 54624 Thessaloniki, Greece
| | - Chrysoula Margioula-Siarkou
- 2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, 54624 Thessaloniki, Greece
| | - Aristarchos Almperis
- 2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, 54624 Thessaloniki, Greece
| | - Eleftherios Vavoulidis
- 2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, 54624 Thessaloniki, Greece
| | - Antonio Simone Laganà
- Unit of Gynecologic Oncology, ARNAS 'Civico-Di Cristina-Benfratelli', Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, I-90127 Palermo, Italy
| | - Konstantinos Dinas
- 2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, 54624 Thessaloniki, Greece
| | - Stamatios Petousis
- 2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, 54624 Thessaloniki, Greece
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Xi M, Yan Y, Duan S, Li T, Szeto IMY, Zhao A. Short-chain fatty acids in breast milk and their relationship with the infant gut microbiota. Front Microbiol 2024; 15:1356462. [PMID: 38440144 PMCID: PMC10909814 DOI: 10.3389/fmicb.2024.1356462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 01/29/2024] [Indexed: 03/06/2024] Open
Abstract
Introduction The short-chain fatty acids (SCFAs) contained in breast milk play a key role in infant growth, affecting metabolism and enhancing intestinal immunity by regulating inflammation. Methods In order to examine the associations between the microbiota and SCFA levels in breast milk, and explore the roles of SCFAs in regulating the infant gut microbiota, we enrolled 50 paired mothers and infants and collected both breast milk and infant fecal samples. Breast milk SCFA contents were determined by UPLC-MS, and whole genome shotgun sequencing was applied to determine the microbial composition of breast milk and infant feces. The SCFA levels in breast milk were grouped into tertiles as high, medium, or low, and the differences of intestinal microbiota and KEGG pathways were compared among groups. Results The results demonstrated that breast milk butyric acid (C4) is significantly associated with Clostridium leptum richness in breastmilk. Additionally, the specific Bifidobacterium may have an interactive symbiosis with the main species of C4-producing bacteria in human milk. Women with a low breast milk C4 tertile are associated with a high abundance of Salmonella and Salmonella enterica in their infants' feces. KEGG pathway analysis further showed that the content of C4 in breast milk is significantly correlated with the infants' metabolic pathways of lysine and arginine biosynthesis. Discussion This study suggests that interactive symbiosis of the microbiota exists in breast milk. Certain breast milk microbes could be beneficial by producing C4 and further influence the abundance of certain gut microbes in infants, playing an important role in early immune and metabolic development.
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Affiliation(s)
- Menglu Xi
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yalu Yan
- Inner Mongolia Yili Industrial Group Co. Ltd., Yili Maternal and Infant Nutrition Institute (YMINI), Beijing, China
- Inner Mongolia Dairy Technology Research Institute Co. Ltd., Hohhot, China
| | - Sufang Duan
- Inner Mongolia Yili Industrial Group Co. Ltd., Yili Maternal and Infant Nutrition Institute (YMINI), Beijing, China
- Inner Mongolia Dairy Technology Research Institute Co. Ltd., Hohhot, China
| | - Ting Li
- Inner Mongolia Yili Industrial Group Co. Ltd., Yili Maternal and Infant Nutrition Institute (YMINI), Beijing, China
- Inner Mongolia Dairy Technology Research Institute Co. Ltd., Hohhot, China
| | - Ignatius Man-Yau Szeto
- Inner Mongolia Yili Industrial Group Co. Ltd., Yili Maternal and Infant Nutrition Institute (YMINI), Beijing, China
- Inner Mongolia Dairy Technology Research Institute Co. Ltd., Hohhot, China
- National Center of Technology Innovation for Dairy, Hohhot, China
| | - Ai Zhao
- Vanke School of Public Health, Tsinghua University, Beijing, China
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Hartmann C, Kaiser AM, Moche W, Weiss S, Raffesberg W, Scharf S, Graf-Rohrmeister K, Thanhaeuser M, Haiden N, Uhl M. Persistent Organic Pollutants in Austrian Human Breast Milk Collected between 2013 and 2016. J Xenobiot 2024; 14:247-266. [PMID: 38390995 PMCID: PMC10885091 DOI: 10.3390/jox14010015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/17/2024] [Accepted: 02/01/2024] [Indexed: 02/24/2024] Open
Abstract
Breast milk holds an immense nutritional value as it contains health-promoting substances in a unique, optimal form. Additionally, breast milk's significance extends to health and environmental protection, as it serves as an indicator of both maternal and infant exposure. In this study, breast milk samples collected in 2013 and in 2014-2016 from mothers in Vienna (Austria) were analysed for polybrominated diphenyl ethers (PBDE) and per- and polyfluoroalkyl substances (PFAS), as well as further substances which have been listed under the Stockholm Convention on Persistent Organic Pollutants (POPs) due to their persistent, bioaccumulative and toxic properties. The total concentration of the PBDE congeners in the samples (n = 18, sampled 2013) ranged from 0.055 to 52 ng/g lipid, and from 0.002 to 2.5 ng/g breast milk. In the pooled sample, the sum of PBDEs was detected at a level of 4.4 ng/g lipid. Based on the 2014-2016 study population, certain PFAS were detected in all samples (n = 40). Exposure to the sum of four specific PFAS including perfluorooctanesulphonate (PFOS), perfluorooctanoic acid (PFOA), perfluoro-n-nonanoic acid (PFNA) and perfluoro-1-hexanesulfonate (PFHxS) ranged between 0.014 and 0.12 ng/L breast milk. In the pooled sample, PFOS and PFOA were found in concentrations of 0.025 ng/g and of 0.045 ng/g, respectively. In addition, the first generation of POPs, mainly organochlorine compounds, was measured in a pooled sample of breast milk from participants sampled in 2014-2016 as part of the WHO/UNEP breast milk monitoring program and compared to the POPs measured in pooled samples collected in 1987/1988 and 1992/1993, respectively. Therefore, this paper demonstrates the effectiveness of the Stockholm Convention on POPs by comparing the Austrian results from the WHO/UNEP global breast milk study from 1987 to 2016. However, the data also show that, despite these reductions, health-relevant levels are still being reached, particularly in terms of children's health when the presence of the new generation of POPs, such as PBDEs and PFAS, in human breast milk is taken into account.
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Affiliation(s)
| | | | - Wolfgang Moche
- Environment Agency Austria, Spittelauer Laende 5, 1090 Vienna, Austria
| | - Stefan Weiss
- Environment Agency Austria, Spittelauer Laende 5, 1090 Vienna, Austria
| | | | - Sigrid Scharf
- Environment Agency Austria, Spittelauer Laende 5, 1090 Vienna, Austria
| | | | - Margarita Thanhaeuser
- Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Nadja Haiden
- Department of Neonatology, Kepler University Hospital, Krankenhausstraße 26-30, 4020 Linz, Austria
| | - Maria Uhl
- Environment Agency Austria, Spittelauer Laende 5, 1090 Vienna, Austria
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Pesonen A, Hakomäki H, Kokki H, Ranta VP, Rinne V, Kokki M. Breast milk oxycodone concentrations in mothers given oxycodone for post-Caesarean delivery pain management. Br J Clin Pharmacol 2024. [PMID: 38308454 DOI: 10.1111/bcp.16008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/15/2023] [Accepted: 01/13/2024] [Indexed: 02/04/2024] Open
Abstract
AIMS Both effective analgesia and early breastfeeding play an important role in maternal and neonatal well-being after Caesarean delivery. We studied controlled-release oxycodone tablet treatment for postoperative pain management and determined the excretion of oxycodone into breast milk. METHODS Controlled-release oxycodone/naloxone 10/5-mg tablets (n = 21) or controlled-release oxycodone 10-mg tablets (n = 22) were administered to mothers twice a day for the first 3 days after elective Caesarean delivery as a part of multimodal analgesia. Maternal plasma and breast milk samples were collected daily. Oxycodone, noroxycodone, oxymorphone and noroxymorphone concentrations were analysed with ultra-performance liquid chromatography-mass spectrometry. Maternal pain intensity was recorded with an 11-point Numeric Rating Scale (0-10). Neonatal oxycodone exposure was estimated by simulating five different exposure scenarios, including the highest possible exposure through breast milk. RESULTS The mean oxycodone and noroxycodone milk-to-maternal plasma ratios were 3.2 and 3.0, respectively. A strong correlation was found between plasma and breast milk oxycodone (R2 = 0.87) and noroxycodone concentrations (R2 = 0.91). In the simulated highest neonatal exposure scenario, the neonate's maximum plasma concentration was estimated to be 5.4 ng/mL and the estimated weight-adjusted infant oxycodone dose was less than 10% of the maternal dose. Pain intensities were similarly low between the two treatment groups. CONCLUSIONS The oxycodone dose received from colostrum and breast milk during the first three postoperative days after Caesarean delivery is assumed safe for healthy, term neonates, but in extreme cases it is possible for the neonate to receive a dose through breast milk that may elicit opioid effects.
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Affiliation(s)
- Aino Pesonen
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | | | - Hannu Kokki
- School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Veli-Pekka Ranta
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | | | - Merja Kokki
- Department of Anesthesia and Intensive Care, Kuopio University Hospital, Kuopio, Finland
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Tenenbaum Weiss Y, Ovnat Tamir S, Globus O, Marom T. Protective Characteristics of Human Breast Milk on Early Childhood Otitis Media: A Narrative Review. Breastfeed Med 2024; 19:73-80. [PMID: 38386988 DOI: 10.1089/bfm.2023.0237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Introduction: Human breast milk (HBM) contains a complex and dynamically changing variety of factors that contribute to the infant's developing immune system's ability to fight upper respiratory tract infections, including otitis media (OM). We sought to summarize the current evidence on the protective characteristics of HBM, through direct or donated feeding, toward early childhood OM. Methods: For this narrative review, we performed a literature search on OM in the context of HBM feeding in the PubMed, Embase, and Google Scholar databases, between January 1, 2008, and July 1, 2023. Results: Immunoglobulin A (IgA) provides a short-term immunity of 2-3 days against otopathogens causing OM. IgA-mediated immunity is effective against OM up to 7 months of age if breastfeeding continues. The role of transferred IgM and IgG in HBM is unclear. Although there is a potential protective value of microRNA, hormones, oligosaccharides, stem cells, and interleukins present in HBM, their role is unclear. Any duration of breastfeeding is superior to no breastfeeding in OM risk reduction, with a big variability among studies (odds ratio 0.23-0.81, depending on the duration). Duration of breastfeeding ≥6 months was found to be the most effective in OM risk reduction, but there was no evidence of continued benefits after 2 years of age. Expressed breastfeeding was not shown to be more beneficial. The protective values of donor HBM against OM are still undetermined. Conclusion: HBM has numerous components that contribute to protection against early childhood OM.
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Affiliation(s)
- Yarden Tenenbaum Weiss
- Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ben Gurion University Faculty of Health Sciences, Ashdod, Israel
| | - Sharon Ovnat Tamir
- Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ben Gurion University Faculty of Health Sciences, Ashdod, Israel
| | - Omer Globus
- Neonatal Intensive Care Unit, Samson Assuta Ashdod University Hospital, Ben Gurion University Faculty of Health Sciences, Ashdod, Israel
| | - Tal Marom
- Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ben Gurion University Faculty of Health Sciences, Ashdod, Israel
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Eijsink JFH, Wieringa A, Vries-Koenjer MTLM, Horst PGJT. Anidulafungin Levels in Breast Milk After Cessation of Treatment: A Case Report. Breastfeed Med 2024; 19:134-136. [PMID: 38174985 DOI: 10.1089/bfm.2023.0246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Background: Anidulafungin has poor oral bioavailability, with hardly any available information on how it affects breast milk, oral absorption, or gastrointestinal side effects in the infant. Case Presentation: A 40-year-old woman who recently gave birth to a healthy infant was treated for a period of 14 days for a Candida glabrata with 100 mg anidulafungin once a day. The department of clinical pharmacy was consulted to provide advice on how long the patient had to wait after ceasing anidulafungin before it was safe to start breastfeeding, with regard to preventing possible side effects of the drug to the infant, such as diarrhea or cholestasis and increase in liver enzyme values. The advice of the hospital pharmacist was pragmatic: to start breastfeeding within 2 days after the medication was discontinued based on half-time. Results: Owing to this lack of information, we measured anidulafungin concentrations in breast milk and found low levels. Conclusion: We concluded that anidulafungin is detectable in breast milk until 32 hours after anidulafungin treatment was stopped, and that no side effects were observed by the infant.
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Affiliation(s)
- Job F H Eijsink
- Department of Clinical Pharmacy, Isala, Zwolle, The Netherlands
| | - André Wieringa
- Department of Clinical Pharmacy, Isala, Zwolle, The Netherlands
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Taksande AA, Tote S, Taksande A, Javvaji CK. Knowledge, Attitudes, and Perceptions of Medical and Paramedical Students Toward Human Milk Banks and Breast Milk Donation. Cureus 2024; 16:e55145. [PMID: 38558671 PMCID: PMC10979709 DOI: 10.7759/cureus.55145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 02/28/2024] [Indexed: 04/04/2024] Open
Abstract
Background and objectives Human milk benefits for both mothers and babies are widely acknowledged. Human milk banks (HMBs) are essential in providing newborns who would not otherwise have access to pasteurized and stored human milk. The objective of this research was to investigate the understanding, opinions, and outlooks of medical and paramedical students regarding breast milk donation and the concept of an HMB. Material and methods A total of 398 professional female students specializing in physiotherapy, nursing, and medicine were given an online self-administered questionnaire as part of a descriptive cross-sectional study. Data on the characteristics, HMB knowledge, awareness levels, and attitudes toward HMB and breast milk donation were to be gathered through the questionnaire. Every student's answer to the survey was kept private and confidential. Result According to the survey, 188 students (47.24%) belong to the medical college, 126 students (31.66%) belong to the physiotherapy college, and the remaining 84 students (21.11%) are from the nursing college. A total of 294 students (74.12%) had heard about human milk banking before and received information from health professionals (195 students, 48.99%), the news (67 students, 16.83%), and family and friends (61 students, 15.33%). However, only 224 students (56.28%) are willing to feed their babies with HMB milk in the future. On the other hand, 216 students (54.27%) are ready to donate breast milk to HMB. The majority of students have a favorable opinion of breast milk donation. A staggering 394 students (98.99%) think that donating human milk can save babies. Furthermore, 379 students (95.23%) think that all the nutrients needed for a baby's healthy development are found in human milk. Merely 350 students (87.93%) think that breastfeeding does not result in malnourishment for either the mother or the baby. When there is an excess of milk, the majority of students (378 or 94.97%) think that there is nothing wrong with donating it. Moreover, 312 (80.41%) students are happy to donate milk in the future. A total of 373 students (93.71%) are overjoyed that a sick baby will survive because of their donated milk. Only 100 students (25.12%) will give milk, though, and only to the infants of their friends and relatives, never to complete strangers. Conclusion A dearth of knowledge pertaining to human milk banking is rampant among medical and paramedical female students, yet the gravity of the circumstances remains concealed. Consequently, it is imperative to extensively educate all Indian communities about the concept of human milk banking to gain widespread acceptance. This research sheds light on the issue and promotes scientific knowledge of HMB, as many students are unaware of it.
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Affiliation(s)
- Anugya A Taksande
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sachin Tote
- Anatomy, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Amar Taksande
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Chaitanya Kumar Javvaji
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Chen HC, Cao WC, Liu XF, Liu X, Cheng QY, Zhou Y, Wen S. [Contamination levels of perfluorinated and polyfluoroalkyl compounds in breast milk and assessment of their exposure risk to infants]. Se Pu 2024; 42:211-216. [PMID: 38374602 PMCID: PMC10877470 DOI: 10.3724/sp.j.1123.2023.09023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024] Open
Abstract
The purposes of this study are to explore the contamination levels of perfluorinated and polyfluoroalkyl substances (PFASs) in breast milk and assess their exposure risk to infants. Based on data from a birth cohort study conducted in Yingcheng, Hubei Province, from 2018 to 2021, the contents of 23 types of PFASs in the breast milk of 324 pregnant women were determined using isotope dilution-high performance liquid chromatography-tandem mass spectrometry. Multiple linear regression was then performed to analyze the effects of various demographic characteristics and eating habits on the concentration of PFASs in breast milk. The daily PFASs intake of infants through breast milk was estimated, and the exposure risk of infants was also assessed. The results revealed that 23 types of PFASs in breast milk had good linear relationships in the range of 0.2-100 ng/mL, with correlation coefficients greater than 0.992. The limits of detection were 5-42 pg/mL, the limits of quantification were 15-126 pg/mL, the recoveries were 65.6%-108.1%, and the relative standard deviations were 1.6%-12.8%. Perfluorooctane sulfonic acid (PFOS), perfluorooctanoate acid (PFOA), and perfluorohexanesulfonic acid (PFHxS), with median concentrations of 200.7, 63.5, and 25.2 pg/mL, respectively, were the main PFASs found in breast milk. The detection rates of these three contaminants were higher than 80%, whereas the detection rates of other compounds were lower than 45%. The results of multiple linear regression showed that older pregnant women and a higher frequency of pickled food intake may be related to increased PFAS levels in breast milk whereas a higher frequency of legume intake may be related to decreased PFAS levels in breast milk. The median estimated daily intakes (EDIs) of PFOS, PFOA, and PFHxS for infants were 25.1, 7.9, and 3.2 ng/(kg·d), respectively. In summary, this study found notable PFAS levels in breast milk in Yingcheng, Hubei Province. Among these PFASs, PFOS, PFOA, and PFHxS were the main contaminants. Maternal age as well as pickled food and legume intake may affect the PFAS level in breast milk. The health risk of PFAS intake through breast milk to some infants is worthy of attention and further study.
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Affiliation(s)
- Hai-Chuan Chen
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Center for Disease Control and Prevention, Wuhan 430079, China
| | - Wen-Cheng Cao
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Center for Disease Control and Prevention, Wuhan 430079, China
| | - Xiao-Fang Liu
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Center for Disease Control and Prevention, Wuhan 430079, China
| | - Xiao Liu
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Center for Disease Control and Prevention, Wuhan 430079, China
| | - Qing-Yun Cheng
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Center for Disease Control and Prevention, Wuhan 430079, China
| | - Yan Zhou
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Center for Disease Control and Prevention, Wuhan 430079, China
| | - Sheng Wen
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Center for Disease Control and Prevention, Wuhan 430079, China
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Saenger T, Schulte MF, Vordenbäumen S, Hermann FC, Bertelsbeck J, Meier K, Bleck E, Schneider M, Jose J. Structural Analysis of Breast-Milk α S1-Casein: An α-Helical Conformation Is Required for TLR4-Stimulation. Int J Mol Sci 2024; 25:1743. [PMID: 38339021 PMCID: PMC10855866 DOI: 10.3390/ijms25031743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/19/2024] [Accepted: 01/21/2024] [Indexed: 02/12/2024] Open
Abstract
Breast-milk αS1-casein is a Toll-like receptor 4 (TLR4) agonist, whereas phosphorylated αS1-casein does not bind TLR4. The objective of this study was to analyse the structural requirements for these effects. In silico analysis of αS1-casein indicated high α-helical content with coiled-coil characteristics. This was confirmed by CD-spectroscopy, showing the α-helical conformation to be stable between pH 2 and 7.4. After in vitro phosphorylation, the α-helical content was significantly reduced, similar to what it was after incubation at 80 °C. This conformation showed no in vitro induction of IL-8 secretion via TLR4. A synthetic peptide corresponding to V77-E92 of αS1-casein induced an IL-8 secretion of 0.95 ng/mL via TLR4. Our results indicate that αS1-casein appears in two distinct conformations, an α-helical TLR4-agonistic and a less α-helical TLR4 non-agonistic conformation induced by phosphorylation. This is to indicate that the immunomodulatory role of αS1-casein, as described before, could be regulated by conformational changes induced by phosphorylation.
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Affiliation(s)
- Thorsten Saenger
- Institute for Pharmaceutical and Medicinal Chemistry, University of Münster, PharmaCampus, Correnstr. 48, 48149 Münster, Germany; (T.S.); (M.F.S.)
| | - Marten F. Schulte
- Institute for Pharmaceutical and Medicinal Chemistry, University of Münster, PharmaCampus, Correnstr. 48, 48149 Münster, Germany; (T.S.); (M.F.S.)
| | - Stefan Vordenbäumen
- Department of Rheumatology and Hiller Research Unit Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Fabian C. Hermann
- Institute for Pharmaceutical Biology and Phytochemie, University of Münster, PharmaCampus, Correnstr. 48, 48149 Münster, Germany
| | - Juliana Bertelsbeck
- Institute for Pharmaceutical and Medicinal Chemistry, University of Münster, PharmaCampus, Correnstr. 48, 48149 Münster, Germany; (T.S.); (M.F.S.)
| | - Kathrin Meier
- Institute for Pharmaceutical and Medicinal Chemistry, University of Münster, PharmaCampus, Correnstr. 48, 48149 Münster, Germany; (T.S.); (M.F.S.)
| | - Ellen Bleck
- Department of Rheumatology and Hiller Research Unit Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Matthias Schneider
- Department of Rheumatology and Hiller Research Unit Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Joachim Jose
- Institute for Pharmaceutical and Medicinal Chemistry, University of Münster, PharmaCampus, Correnstr. 48, 48149 Münster, Germany; (T.S.); (M.F.S.)
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22
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Patel AL, Tan A, Bucek A, Janes J, McGee K, Mulcahy D, Meier P, Johnson TJ. Where does the time go? Temporal patterns of pumping behaviors in mothers of very preterm infants vary by sociodemographic and clinical factors. Front Nutr 2024; 11:1278818. [PMID: 38352705 PMCID: PMC10861725 DOI: 10.3389/fnut.2024.1278818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/08/2024] [Indexed: 02/16/2024] Open
Abstract
Background Mothers of very preterm (<32 weeks gestational age [GA]) infants are breast pump dependent and have shorter duration of milk provision than mothers of term infants. The opportunity (i.e., time) cost of pumping and transporting mother's own milk (MOM) from home to the NICU may be a barrier. There is a paucity of data regarding how much time mothers actually spend pumping. Objective To investigate the variation in pumping behavior by postpartum week, maternal characteristics, and infant GA. Methods Prospectively collected pump log data from mothers enrolled in ReDiMOM (Reducing Disparity in Mother's Own Milk) randomized, controlled trial included pumping date and start time and end time of each pumping session for the first 10 weeks postpartum or until the infant was discharged from the NICU, whichever occurred first. Outcomes included number of daily pumping sessions, number of minutes spent pumping per day, and pumping behaviors during 24-h periods, aggregated to the postpartum week. Medians (interquartile ranges) were used to describe outcomes overall, and by maternal characteristics and infant GA. Results Data included 13,994 pump sessions from 75 mothers. Maternal characteristics included 55% Black, 35% Hispanic, and 11% White and 44% <30 years old. The majority (56%) of infants were born at GA 28-31 weeks. Mothers pumped an average of less than 4 times per day, peaking in postpartum week 2. After accounting for mothers who stopped pumping, there was a gradual decrease in daily pumping minutes between postpartum weeks 2 (89 min) and 10 (46 min). Black mothers pumped fewer times daily than non-Black mothers after the first 2 weeks postpartum. Conclusion On average mothers pumped less intensively than the minimum recommendation of 8 times and 100 min per day. However, these pumping behaviors represent significant maternal opportunity costs that should be valued by the institution and society at large.
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Affiliation(s)
- Aloka L. Patel
- Department of Pediatrics, Rush University Medical Center, Chicago, IL, United States
| | - Amelia Tan
- Department of Pediatrics, Rush University Medical Center, Chicago, IL, United States
| | - Amelia Bucek
- Northwestern University, Chicago, IL, United States
| | - Judy Janes
- Department of Pediatrics, Rush University Medical Center, Chicago, IL, United States
| | - Katie McGee
- Department of Pediatrics, Rush University Medical Center, Chicago, IL, United States
| | - Delaney Mulcahy
- Department of Pediatrics, Rush University Medical Center, Chicago, IL, United States
| | - Paula Meier
- Department of Pediatrics, Rush University Medical Center, Chicago, IL, United States
| | - Tricia J. Johnson
- Department of Health Systems Management, Rush University, Chicago, IL, United States
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23
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Raju SB, Rathi M, Mahajan S. Editorial: Case reports in nephrology. Front Med (Lausanne) 2024; 10:1278138. [PMID: 38348234 PMCID: PMC10859465 DOI: 10.3389/fmed.2023.1278138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 11/30/2023] [Indexed: 02/15/2024] Open
Affiliation(s)
- Sree Bhushan Raju
- Department of Nephrology, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - Manish Rathi
- Department of Nephrology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, Haryana, India
| | - Sandeep Mahajan
- Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India
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24
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Briere CE, Gomez J. Fresh Parent's Own Milk for Preterm Infants: Barriers and Future Opportunities. Nutrients 2024; 16:362. [PMID: 38337647 PMCID: PMC10857054 DOI: 10.3390/nu16030362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/19/2024] [Accepted: 01/20/2024] [Indexed: 02/12/2024] Open
Abstract
While direct at-the-breast feeding is biologically optimal, Neonatal Intensive Care Unit (NICU) admission due to infant immaturity or illness often necessitates the expression and storage of parent's milk. The provision of freshly expressed (never stored) parent's own milk to preterm infants is not widely prioritized, and this article provides an exploration of NICU practices and their implications for feeding premature or ill infants with parent's own milk. In this article, we discuss the potential biological benefits of fresh parent's own milk, highlighting its dynamic components and the changes incurred during storage. Research suggests that fresh milk may offer health advantages over stored milk. The authors advocate for further research, emphasizing the need for standardized definitions. Research is needed on the biological impact of fresh milk, both short- and long-term, as well as defining and understanding healthcare economics when using fresh milk.
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Affiliation(s)
- Carrie-Ellen Briere
- Elaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, MA 01003, USA
- Institute of Nursing Research and Evidence-Based Practice, Connecticut Children’s, Hartford, CT 06106, USA
| | - Jessica Gomez
- Department of Pediatrics/Neonatal-Perinatal Medicine, McGovern School of Medicine, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA;
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25
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McMullan P, Yaghi M, Truong TM, Rothe M, Murase J, Grant-Kels JM. Safety of dermatologic medications in pregnancy and lactation: An Update - Part I: Pregnancy. J Am Acad Dermatol 2024:S0190-9622(24)00109-9. [PMID: 38280679 DOI: 10.1016/j.jaad.2023.10.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/06/2023] [Accepted: 10/08/2023] [Indexed: 01/29/2024]
Abstract
The breadth of therapeutic options for the management of dermatologic skin conditions continues to expand rapidly as exemplified by biologics and small molecule drug development. While dermatologists and healthcare providers are aware of the underlying mechanisms and indications for these therapeutics, there is a recognized practice gap due to an incomplete understanding of the safety of these medications in women of childbearing age during the prepartum, antepartum and postpartum phases. Although a two-part continuing medical education review was published regarding the prescribing practices and safety profiles of these new therapeutics in women of childbearing age while pregnant or lactating in 20141,2, many new medications have been approved since then. Herein, we will update the safety of dermatologic therapies during pregnancy and Part II will review the safety of medications during lactation.
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Affiliation(s)
- Patrick McMullan
- Department of Dermatology, University of Connecticut Health Center, Farmington, CT
| | - Marita Yaghi
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, FL
| | - Thu M Truong
- School of Medicine, Rutgers New Jersey Medical School, Newark, NJ; Center for Dermatology, Rutgers Robert Wood Johnson Medical School, Somerset, NJ
| | - Marti Rothe
- Department of Dermatology, University of Connecticut Health Center, Farmington, CT
| | - Jenny Murase
- Department of Dermatology, University of California, San Francisco, CA; Palo Alto Foundation Medical Group, Mountain View, CA
| | - Jane M Grant-Kels
- Department of Dermatology, University of Connecticut Health Center, Farmington, CT; Department of Dermatology, University of Florida, Gainesville, FL.
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26
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Hashemi Javaheri FS, Karbin K, Senobari MA, Hakim HG, Hashemi M. The association between maternal body mass index and breast milk composition: a systematic review. Nutr Rev 2024:nuad174. [PMID: 38273741 DOI: 10.1093/nutrit/nuad174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Abstract
CONTEXT Breast milk composition is influenced by many factors, ranging from maternal nutritional status to infant sex. Previous studies have explored the relationship between maternal body mass index (BMI) and breast milk composition; however, the findings have been inconsistent and controversial. OBJECTIVE To systematically review the evidence on the association of maternal weight and BMI with breast milk composition. DATA SOURCES The PubMed and Scopus databases were searched up to May 3, 2023, using the following search strategy: ("maternal weight" OR "maternal BMI" OR "mother's weight" OR "mother's BMI") AND ("maternal milk" OR "human milk" OR "breast milk"). DATA EXTRACTION A total of 83 publications, involving data from more than 11 310 lactating women, were identified. All extracted data were compiled, compared, and critically analyzed. DATA ANALYSIS Overall, maternal BMI was associated with higher levels of leptin and insulin, and the ratio of omega-6 to omega-3 polyunsaturated fatty acids in breast milk. However, no conclusive associations were found between maternal BMI and the levels of energy, macronutrients, micronutrients, and other components of breast milk. CONCLUSIONS This systematic review provides robust evidence supporting a positive correlation between maternal BMI and breast milk concentrations of leptin, insulin, and the omega-6 to omega-3 polyunsaturated fatty acid ratio. Nevertheless, disparities in findings are noticeable for other constituents of breast milk. To comprehensively grasp the influence of maternal weight and BMI on breast milk composition, further research endeavors are imperative. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42023458667.
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Affiliation(s)
- Fatemeh Sadat Hashemi Javaheri
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Karim Karbin
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Mohammad Amin Senobari
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hakime Ghadiri Hakim
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Hashemi
- Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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27
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Mihatsch WA, Stahl B, Braun U. The Umbilical Cord Creatine Flux and Time Course of Human Milk Creatine across Lactation. Nutrients 2024; 16:345. [PMID: 38337631 PMCID: PMC10857059 DOI: 10.3390/nu16030345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/13/2024] [Accepted: 01/16/2024] [Indexed: 02/12/2024] Open
Abstract
(1) Background: The aim of the present paper was to study fetal and infant creatine (Cr) supply to improve nutrition and neuroprotection in term and especially in preterm infants. The primary outcomes were the placental Cr flux at the end of pregnancy and the time course of human milk (HM) Cr. (2) Methods: The estimation of placental Cr flux was based on umbilical arterial and venous cord blood Cr in 10 term infants after elective caesarian section. HM Cr, creatinine (Crn), and macronutrients were measured longitudinally in 10 mothers across the first 6 months of breastfeeding. (3) Results: At the end of pregnancy, the mean fetal Cr flux was negative (-2.07 mmol/min). HM Cr was highest in colostrum, decreased significantly within the first 2 weeks of breastfeeding (p < 0.05), and did not change significantly thereafter. HM Cr was not correlated with HM Crn or macronutrient composition. (4) Conclusions: The present data suggest that fetal endogenous Cr synthesis covers the needs at the end of pregnancy. However, high colostrum Cr and HM Cr levels, independent of macronutrient composition, suggest that there may be a critical Cr demand immediately after birth that needs to be covered by enteral supply.
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Affiliation(s)
- Walter Alexander Mihatsch
- Department of Pediatrics, Ulm University, 89075 Ulm, Germany
- Department of Health Management, Neu-Ulm University of Applied Sciences, 89231 Neu-Ulm, Germany
| | - Bernd Stahl
- Danone Nutricia Research, 3584 CT Utrecht, The Netherlands;
- Department of Chemical Biology & Drug Discovery, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584 CT Utrecht, The Netherlands
| | - Ulrike Braun
- Alzchem Trostberg GmbH, 83308 Trostberg, Germany;
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28
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Hall M, Valencia CM, Soma-Pillay P, Luyt K, Jacobsson B, Shennan A. Effective and simple interventions to improve outcomes for preterm infants worldwide: The FIGO PremPrep-5 initiative. Int J Gynaecol Obstet 2024. [PMID: 38264849 DOI: 10.1002/ijgo.15269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/07/2023] [Accepted: 11/11/2023] [Indexed: 01/25/2024]
Abstract
Preterm birth remains the leading cause of mortality among under-5's and is a major contributor to the reduction in quality-of-life adjusted years and reduction in human capital. Globally, there are many interventions and care bundles that aim to reduce the impact of preterm birth once preterm labor has ensued and into the neonatal period; not all of these are applicable in all settings. Here, we introduce the FIGO PremPrep-5 initiative, which aims to disseminate key information on the most simple and effective interventions with the aim of increasing implementation globally. Before delivery, we recommend a course of antenatal corticosteroids, and intrapartum magnesium sulfate. At delivery, we recommend delayed cord clamping. Postnatally, we recommend early feeding with breast milk and immediate kangaroo care. While there are many other interventions that may improve outcomes at the time of labor and after preterm birth, these are clinically effective and relatively inexpensive options that can be practiced in most settings and supplemented with more advanced care. We include examples of a training video and infographics that will be used for dissemination.
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Affiliation(s)
- Megan Hall
- Department of Women and Children's Health, St Thomas' Hospital, King's College London, London, UK
| | - Catalina M Valencia
- Department of Obstetrics and Gynecology, Universidad CES, Medellín, Colombia
- Maternal Fetal Medicine Unit, Clinica del Prado, Medellín, Colombia
| | - Priya Soma-Pillay
- Department of Obstetrics and Gynecology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Steve Biko Academic Hospital, Pretoria, South Africa
| | - Karen Luyt
- Bristol Medical School, University of Bristol, Bristol, UK
- Neonatology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Bo Jacobsson
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Obstetrics and Gynecology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Genetics and Bioinformatics, Domain of Health Data and Digitalization, Institute of Public Health, Oslo, Norway
| | - Andrew Shennan
- Department of Women and Children's Health, St Thomas' Hospital, King's College London, London, UK
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De Bernardo G, D’Urso G, Spadarella S, Giordano M, Leone G, Casapullo A. Analysis of the Fecal Metabolomic Profile in Breast vs. Different Formula Milk Feeding in Late Preterm Infants. Metabolites 2024; 14:72. [PMID: 38276307 PMCID: PMC10820811 DOI: 10.3390/metabo14010072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/12/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024] Open
Abstract
Human milk is the gold standard for infant nutrition, but when it is not available or insufficient to satisfy the needs of the infant, formula milk is proposed as an effective substitute. A prospective observational cohort study was conducted on late preterm infants fed with breast and two different formula milks. On this basis, they were divided into three groups: group FMPB (fed with formula + postbiotic), group FM (fed with standard formula), and group BM (breastfed). Stool samples for a metabolomic study were collected at T0 (5-7 days after birth), T1 (30 days of life), and T2 (90 days of life), giving rise to 74 samples analyzed via liquid chromatography coupled with high-resolution mass spectrometry. The T0, T1, and T2 LC-MS raw data were processed for Partial Least Square Discriminant Analysis (PLS-DA), followed by a statistical analysis. This preliminary study highlighted a good overlapping between the fecal metabolome of breast and substitute feeding systems, confirming the efficacy of the formula preparations as breast milk substitutes. Moreover, several similarities were also detected between the FMPB and BM metabolome, highlighting that the addition of a postbiotic to standard formula milk could be more effective and considered a better alternative to breast milk.
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Affiliation(s)
- Giuseppe De Bernardo
- Division of Pediatrics Neonatology and NICU, Ospedale Buon Consiglio Fatebenefratelli, 80123 Naples, Italy; (S.S.); (G.L.)
| | - Gilda D’Urso
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 132, 84084 Fisciano, Italy;
| | - Simona Spadarella
- Division of Pediatrics Neonatology and NICU, Ospedale Buon Consiglio Fatebenefratelli, 80123 Naples, Italy; (S.S.); (G.L.)
| | - Maurizio Giordano
- Department of Clinical Medicine and Surgery, Federico II University, 80138 Naples, Italy;
| | - Giuseppina Leone
- Division of Pediatrics Neonatology and NICU, Ospedale Buon Consiglio Fatebenefratelli, 80123 Naples, Italy; (S.S.); (G.L.)
| | - Agostino Casapullo
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 132, 84084 Fisciano, Italy;
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30
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Mukai Y, Doki K, Suzuki Y, Homma M. Utilizing the dry spot method to monitor the concentrations of biologic agents in breast milk. Br J Clin Pharmacol 2024; 90:368-369. [PMID: 37875351 DOI: 10.1111/bcp.15929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 10/06/2023] [Indexed: 10/26/2023] Open
Affiliation(s)
- Yuji Mukai
- Department of Pharmacy, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Kosuke Doki
- Department of Pharmacy, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
- Department of Pharmaceutical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Yoshiharu Suzuki
- Department of Pharmacy, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Masato Homma
- Department of Pharmacy, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
- Department of Pharmaceutical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
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31
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Hochmayr C, Toferer M, Hammerl M, Winkler I, Huber E, Urbanek M, Kiechl-Kohlendorfer U, Griesmaier E, Posod A. Breast milk anti-S1RBD immunoglobulin concentrations throughout lactation: An observational report. Acta Paediatr 2024; 113:81-83. [PMID: 37814794 DOI: 10.1111/apa.16997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 08/30/2023] [Accepted: 10/03/2023] [Indexed: 10/11/2023]
Affiliation(s)
- Christoph Hochmayr
- Department of Pediatrics II (Neonatology), Medical University of Innsbruck, Innsbruck, Austria
| | - Martha Toferer
- Department of Obstetrics and Gynecology, Kardinal Schwarzenberg Hospital, Schwarzach im Pongau, Austria
| | - Marlene Hammerl
- Department of Pediatrics II (Neonatology), Medical University of Innsbruck, Innsbruck, Austria
| | - Ira Winkler
- Department of Pediatrics II (Neonatology), Medical University of Innsbruck, Innsbruck, Austria
| | - Eva Huber
- Department of Pediatrics II (Neonatology), Medical University of Innsbruck, Innsbruck, Austria
| | - Martina Urbanek
- Department of Pediatrics II (Neonatology), Medical University of Innsbruck, Innsbruck, Austria
| | | | - Elke Griesmaier
- Department of Pediatrics II (Neonatology), Medical University of Innsbruck, Innsbruck, Austria
| | - Anna Posod
- Department of Pediatrics II (Neonatology), Medical University of Innsbruck, Innsbruck, Austria
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Wilunda C, Israel‐Ballard K, Wanjohi M, Lang'at N, Mansen K, Waiyego M, Kibore M, Kamande E, Zerfu T, Kithua A, Muganda R, Muiruri J, Maina B, Njuguna E, Njeru F, Kiige LW, Codjia P, Samburu B, Mogusu E, Ngwiri T, Mirie W, Kimani‐Murage EW. Potential effectiveness of integrating human milk banking and lactation support on neonatal outcomes at Pumwani Maternity Hospital, Kenya. Matern Child Nutr 2024; 20:e13594. [PMID: 38051296 PMCID: PMC10750015 DOI: 10.1111/mcn.13594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 12/07/2023]
Abstract
We assessed the potential effectiveness of human milk banking and lactation support on provision of human milk to neonates admitted in the newborn unit (NBU) at Pumwani Maternity Hospital, Kenya. This pre-post intervention study collected data from mothers/caregivers and their vulnerable neonates or term babies who lacked sufficient mother's milk for several reasons admitted in the NBU. The intervention included establishing a human milk bank and strengthening lactation support. Preintervention data were collected between 5 October 2018 and 11 November 2018, whereas postintervention data were collected between 4 September 2019 and 6 October 2019. Propensity score-matched analysis was performed to assess the effect of the intervention on exclusive use of human milk, use of human milk as the first feed, feeding intolerance and duration of NBU stay. The surveys included 123 and 116 newborns at preintervention and postintervention, respectively, with 160 newborns (80 in each group) being included in propensity score matched analysis. The proportion of neonates who exclusively used human milk during NBU stay increased from 41.3% preintervention to 63.8% postintervention (adjusted odds ratio [OR]: 2.68; 95% confidence interval [CI]: 1.31, 5.53) and those whose first feed was human milk increased from 55.0% preintervention to 83.3% postintervention (adjusted OR: 5.09; 95% CI: 2.18, 11.88). The mean duration of NBU stay was 27% (95% CI: 5.8%, 44.0%) lower in the postintervention group than in the preintervention group. The intervention did not affect feeding intolerance. Integrating human milk banking and lactation support may improve exclusive use of human milk among vulnerable neonates in a resource limited setting.
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Affiliation(s)
- Calistus Wilunda
- Nutrition and Food Systems UnitAfrican Population and Health Research CenterNairobiKenya
| | | | - Milka Wanjohi
- Nutrition and Food Systems UnitAfrican Population and Health Research CenterNairobiKenya
| | - Nelson Lang'at
- Nutrition and Food Systems UnitAfrican Population and Health Research CenterNairobiKenya
| | - Kimberly Mansen
- Maternal, Newborn, Child Health and Nutrition ProgramPATHSeattleWashingtonUSA
| | | | | | - Eva Kamande
- Nutrition and Food Systems UnitAfrican Population and Health Research CenterNairobiKenya
| | - Taddese Zerfu
- Nutrition and Food Systems UnitAfrican Population and Health Research CenterNairobiKenya
| | | | | | | | | | | | | | - Laura W. Kiige
- Nutrition SectionUNICEF ‐ Kenya Country OfficeNairobiKenya
| | - Patrick Codjia
- Nutrition SectionUNICEF ‐ Kenya Country OfficeNairobiKenya
| | - Betty Samburu
- Nutrition and Dietetics UnitMinistry of HealthNairobiKenya
| | - Esther Mogusu
- Nutrition and Dietetics UnitMinistry of HealthNairobiKenya
| | - Thomas Ngwiri
- Clinical ServicesGertrude's Children's HospitalNairobiKenya
| | - Waithera Mirie
- School of Nursing SciencesUniversity of NairobiNairobiKenya
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Elfarargy MS, Elbadry DH, Ahmad AR, Elhady HA. Neonatal Microbiome: Is it Still Beneficial? Endocr Metab Immune Disord Drug Targets 2024; 24:617-625. [PMID: 37916638 DOI: 10.2174/0118715303238665231010062701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 08/02/2023] [Accepted: 08/29/2023] [Indexed: 11/03/2023]
Abstract
The neonatal microbiome includes all the microorganisms living within or on the surface of the newborn, as well as their genes (i.e., bacteria, fungi, and viruses), which are composed mainly of bacteria. The majority of these microorganisms reside in the gastrointestinal tract (GIT), which is known as the gut microbiome. They include trillions of microbes, which exceed the total number of neonate cells. In this study, we have examined factors affecting neonatal microbiome colonization, various phyla of the microbiome in neonates, and their characteristics. In addition, we have discussed symbiosis and dysbiosis, precipitating diseases, breast milk's role in the neonatal gut microbiome, prebiotics, probiotics, postbiotics, and synbiotics, as well as the airway or respiratory microbiome, and the main role of the neonatal microbiome. We have also discussed neonatal mycobiome and neonatal virome, as well as the research done on the neonatal microbiome.
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Affiliation(s)
- Mohamed Shawky Elfarargy
- Department of Pediatrics, College of Medicine, Jouf University, KSA
- Department of Pediatrics, Faculty of Medicine, Tanta University, Egypt
| | | | - Ahmad Roshdy Ahmad
- Department of Pediatrics, College of Medicine, Assiut University, Egypt
- Department of Pediatrics, College of Medicine, Jouf University, KSA
| | - Hany A Elhady
- Department of Surgery, College of Medicine, Alazhar University, Egypt
- Department of Surgery, College of Medicine, Jouf University, KSA
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Nordeng H, Wegler C, Lindqvist A, Melander E, Magnusson M, Gandia P, Panchaud A, Baranczewski P, Spigset O. Transfer of cetirizine/levocetirizine into human breast milk and estimation of drug exposure to infants through breastfeeding: A human lactation study from the ConcePTION project. Basic Clin Pharmacol Toxicol 2024; 134:153-164. [PMID: 37811726 DOI: 10.1111/bcpt.13948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 10/02/2023] [Accepted: 10/02/2023] [Indexed: 10/10/2023]
Abstract
Data on drug transfer into human breast milk are sparse. This study aimed to quantify concentrations of cetirizine and levocetirizine in breast milk and to estimate drug exposure to infants. Breastfeeding women at least 8 weeks postpartum and using cetirizine or its pure (R)-enantiomer levocetirizine were eligible to participate. Breast milk samples were collected at six predefined times during a dose interval (0, 2, 4, 8, 12 and 24 h after drug intake) at steady state. Infant drug exposure was estimated by calculating the absolute infant dose (AID) and the weight-adjusted relative infant dose (RID). In total, 32 women were eligible for final inclusion, 31 women using cetirizine and one woman using levocetirizine. Means of the individual maximum and average cetirizine milk concentrations were 41.0 and 16.8 μg/L, respectively. Maximum concentrations occurred on average 2.4 h after intake, and the mean half-life in milk was 7.0 h. Estimated AID and RID for cetirizine in a day were 2.5 μg/kg and 1.9%, respectively. The corresponding values for levocetirizine were 1.1 μg/kg and 1.9%. No severe adverse events were reported. Our findings demonstrate that the transfer of cetirizine and levocetirizine into breast milk is low and compatible with breastfeeding.
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Affiliation(s)
- Hedvig Nordeng
- Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Oslo, Norway
| | - Christine Wegler
- Department of Pharmacy, Uppsala Drug Optimization and Pharmaceutical Profiling (UDOPP), Uppsala University, Uppsala, Sweden
| | - Annika Lindqvist
- Department of Pharmacy, Uppsala Drug Optimization and Pharmaceutical Profiling (UDOPP), Uppsala University, Uppsala, Sweden
- Department of Pharmacy, SciLifeLab Drug Discovery and Development Platform, Uppsala University, Uppsala, Sweden
| | - Erik Melander
- Department of Pharmacy, Uppsala Drug Optimization and Pharmaceutical Profiling (UDOPP), Uppsala University, Uppsala, Sweden
| | | | - Peggy Gandia
- Pharmacokinetics and Toxicology laboratory, Toulouse University Hospital, Toulouse, France
- UMR1436-INTHERES, Toulouse National Veterinary School, Toulouse, France
| | - Alice Panchaud
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Service of Pharmacy, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Pawel Baranczewski
- Department of Pharmacy, Uppsala Drug Optimization and Pharmaceutical Profiling (UDOPP), Uppsala University, Uppsala, Sweden
- Department of Pharmacy, SciLifeLab Drug Discovery and Development Platform, Uppsala University, Uppsala, Sweden
| | - Olav Spigset
- Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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Balcells-Esponera C, Borràs-Novell C, López-Abad M, Cubells Serra I, Basseda Puig A, Izquierdo Renau M, Herranz Barbero A, Iglesias-Platas I. Bioactive peptides in preterm human milk: Impact of maternal characteristics and their association to neonatal outcomes. Biofactors 2024; 50:135-144. [PMID: 37584623 DOI: 10.1002/biof.1997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/29/2023] [Indexed: 08/17/2023]
Abstract
Human milk adipokines in term babies seem partially determined by maternal factors and affect infant's development. We aimed to describe bioactive peptide concentration in very preterm human milk and associations to maternal characteristics and postnatal growth. Mothers delivering ≤32 weeks of gestation and their infant/s were recruited. At 4 weeks of lactation, an aliquot of 24-h-pooled milk was collected for exclusively breastfeeding dyads. Insulin, leptin, adiponectin, and milk fat globule epidermal growth factor-8 (MFG-E8) were measured by enzyme-linked immunoabsorbent assay in skimmed milk. One hundred mothers (28.8 ± 2.3 weeks at delivery) provided a milk sample. Milk insulin was related to gestational age, pre-pregnancy body mass index (BMI), and galactagogue treatment (final model: adjusted R2 : 0.330, p < 0.0001; adjusted β coefficients: galactagogue treatment: 0.348, p 0.001; pre-pregnancy BMI: 0.274, p 0.009; gestational age: -0.290, p 0.007). Adiponectin was higher in mothers with gestational diabetes (30.7 ± 6.5 vs. 24.8 ± 8 ng/mL, p 0.044). Leptin was associated with pre-pregnancy BMI (Spearman's ρ: 0.648, p < 0.0001) and MFG-E8 to presence of labor and multiple pregnancy (final linear regression model, R2 : 0.073, p 0.028, adjusted β coefficients: presence of labor -0.229, p 0.050; twins: -0.192, p 0.099). Milk adiponectin was associated with a greater decrease in length z-scores from birth to 28 days (Pearson's r: -0.225, p 0.032) and to discharge (Pearson's r: -0.290, p 0.003). Milk MFG-E8 was lower in milk of mothers whose babies experienced late-onset sepsis (13.3 ± 5.8 vs. 16.8 ± 6.3 μg/mL, p 0.023). Adipokines levels in preterm human milk are partially related to maternal metabolic status. Milk peptide concentration associates with early neonatal growth trajectories.
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Affiliation(s)
- Carla Balcells-Esponera
- Neonatology Department, BCNatal-Centre de Medicina Maternofetal i Neonatologia de Barcelona, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | - Cristina Borràs-Novell
- Neonatology Department, BCNatal-Centre de Medicina Maternofetal i Neonatologia de Barcelona, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Miriam López-Abad
- Neonatology Department, BCNatal-Centre de Medicina Maternofetal i Neonatologia de Barcelona, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | | | | | - Montserrat Izquierdo Renau
- Neonatology Department, BCNatal-Centre de Medicina Maternofetal i Neonatologia de Barcelona, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | - Ana Herranz Barbero
- Neonatology Department, BCNatal-Centre de Medicina Maternofetal i Neonatologia de Barcelona, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Isabel Iglesias-Platas
- Neonatology Department, BCNatal-Centre de Medicina Maternofetal i Neonatologia de Barcelona, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
- Neonatal Intensive Care Unit, Norfolk and Norwich University Hospital Trust, Norwich, UK
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Rawal S, Brimhall D, Aluri J, Cheng JY, Hall N, Moline M. Lemborexant levels in breast milk after single doses in healthy, lactating women. Br J Clin Pharmacol 2024; 90:158-163. [PMID: 37565541 DOI: 10.1111/bcp.15880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/29/2023] [Accepted: 08/05/2023] [Indexed: 08/12/2023] Open
Abstract
AIMS The aim of this study is to determine the cumulative amount of lemborexant (a competitive dual orexin receptor antagonist approved to treat adults with insomnia) excreted in human breast milk and the relative infant dose (RID) as a proportion of daily maternal dose. METHODS E2006-A001-010 was a single-centre, open-label study that enrolled lactating women (≥18 years) who breastfed for ≥5 weeks postpartum. After overnight fasting, subjects received a single 10-mg oral dose of lemborexant. Using a standardized electric pump, milk was sampled before and ≤240 h (10 days) after dosing; combined and total volume were recorded. The cumulative total amount of lemborexant excreted, fraction of dose excreted, daily infant dose and RID were calculated. Lemborexant concentration in human milk was assessed by liquid chromatography with tandem mass spectrometry. RESULTS Eight subjects completed the study. The mean cumulative total amount of lemborexant reached 0.0174 mg (coefficient of variation [CV] 54.5%; 0.174% of lemborexant 10 mg administered) in breast milk at 240 h (10 days); ~70% of excreted lemborexant accumulated in the first 24 h. For an infant weighing 6 kg, the daily infant dose was 0.00290 mg kg-1 (CV 54.5%) and the RID was 1.96% (CV 63.1%) of daily maternal dose. Mild treatment-emergent adverse events were reported in 4 subjects; these all resolved by end of study. CONCLUSION Trace quantities of lemborexant were found in human breast milk. Lemborexant was well tolerated by healthy lactating women.
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Booker LA, Wilson D, Spong J, Fitzgibbon C, Deacon-Crouch M, Lenz KE, Skinner TC. Maternal Circadian Disruption from Shift Work and the Impact on the Concentration of Melatonin in Breast Milk. Breastfeed Med 2024; 19:33-39. [PMID: 38150529 DOI: 10.1089/bfm.2023.0252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
Background and Objective: Melatonin in breast milk exhibits a 24-hour circadian rhythm, present in nighttime breast milk but nearly undetectable in daytime breast milk. Shift work can disrupt the circadian timing of individuals, evident in changes in melatonin in saliva and urine samples. However, it is unknown whether these changes are also reflected in breast milk from a shift working mother. The aim of this study was to investigate whether maternal circadian rhythm disturbance from shift work impacts the melatonin concentration in breast milk. Materials and Methods: Breast milk and saliva samples were collected from 11 shift working mothers at four timepoints across five consecutive days. This included during their day shift or nonworkdays to act as a control, night shift, subsequent night shifts and postnight shift. Where possible, pre- and postfeed collections were also undertaken. Samples were grouped into four-time intervals: 12-6:30 am, 7-11:30 am, 12-6:30 pm, 7-11:30 pm, and melatonin levels (picogram per milliliter) in the breast milk and saliva samples were analyzed. Results: There was a significant decrease in breast milk melatonin (p = 0.026) at the 12-6:30 am time interval on subsequent night shifts, compared with control days. However, there was no overall time and shift type interaction effect (p = 0.70). In addition, no observed difference in melatonin levels was found in saliva samples, or when comparing pre- and postfeed breast milk. Breast milk melatonin however was found to be significantly higher compared with saliva (p > 0.001), at all but one time interval. Conclusion: The findings suggest that there is a potential effect of maternal circadian rhythm disruption from shift work on breast milk melatonin levels. This is an important step in exploring the role of maternal circadian timing and the effect on breast milk composition. Expansion of this research and exploration of other circadian rhythm misalignment sleep disorders on breast milk is highly recommended.
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Affiliation(s)
- Lauren A Booker
- School of Psychology and Public Health, La Trobe University, Bendigo, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
| | - Danielle Wilson
- School of Psychology and Public Health, La Trobe University, Bendigo, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia
| | - Jo Spong
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Cheree Fitzgibbon
- School of Psychology and Public Health, La Trobe University, Bendigo, Australia
| | - Melissa Deacon-Crouch
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Katrin E Lenz
- School of Psychology and Public Health, La Trobe University, Bendigo, Australia
| | - Timothy C Skinner
- School of Psychology and Public Health, La Trobe University, Bendigo, Australia
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Saito J, Yakuwa N, Hosokawa Y, Hamada H, Suzuki T, Sago H, Kaneko K, Yamatani A, Murashima A. Establishment of a measurement system to evaluate breast milk transfer of biological agents using dry filter paper: A multi-institutional study. Br J Clin Pharmacol 2024; 90:146-157. [PMID: 37548054 DOI: 10.1111/bcp.15876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/09/2023] [Accepted: 07/31/2023] [Indexed: 08/08/2023] Open
Abstract
AIMS Information on breastfeeding and safety of biologics in infants is lacking due to difficulties in case collection. We evaluated methods for determining the concentration of biologics in breast milk using a dry filter method that can simplify the collection, storage and transport of breast milk. METHODS To generate dried filter paper (DFP) samples, approximately 30 μL of breast milk was placed onto a Whatman 903 card and punched out. After extraction, the supernatant was measured using an enzyme-linked immunosorbent assay. Three concentrations of each drug were prepared in liquid breast milk (LBM) and DFP samples to determine their stability up to 28 days after storage at 2-8°C or -20°C for LBM and 25 ± 5°C for DFP. LBM and DFP samples were also provided by nursing mothers using biologics during lactation, and drug concentrations in both samples were compared. The agreement between the two measurement methods was confirmed by Bland-Altman analysis. RESULTS Breast milk was provided by 12 mothers who used biologics (tocilizumab, abatacept, etanercept, golimumab, sarilumab and belimumab). The coefficients of variation for within-run and between-run precision for the six drugs were within 15% for both LBM and DFP, and accuracy was within 90%-110% of the quality controls. After 28 days, concentrations remained at more than 90%. The difference between the values obtained by each method was within the acceptable range of error (-12.1 to +16.6 ng/mL). CONCLUSIONS A method for determining the concentration of biologics using DFP is expected to help improve pharmacotherapy for lactating women.
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Affiliation(s)
- Jumpei Saito
- Department of Pharmacy, National Center for Child Health and Development, Tokyo, Japan
| | - Naho Yakuwa
- Pregnancy and Drug Information Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yoshihiko Hosokawa
- Department of Obstetrics and Gynecology, University of Tsukuba Hospital, Ibaraki, Japan
| | - Hiromi Hamada
- Department of Obstetrics and Gynecology, University of Tsukuba Hospital, Ibaraki, Japan
| | - Tomo Suzuki
- Division of Obstetrics, National Center for Child Health and Development, Tokyo, Japan
| | - Haruhiko Sago
- Division of Obstetrics, National Center for Child Health and Development, Tokyo, Japan
| | - Kayoko Kaneko
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Akimasa Yamatani
- Department of Pharmacy, National Center for Child Health and Development, Tokyo, Japan
| | - Atsuko Murashima
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
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Saito Y, Sato K, Jinno S, Nakamura Y, Nobukuni T, Ogishima S, Mizuno S, Koshiba S, Kuriyama S, Ohneda K, Morifuji M. Effect of Nicotinamide Mononucleotide Concentration in Human Milk on Neurodevelopmental Outcome: The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Nutrients 2023; 16:145. [PMID: 38201974 PMCID: PMC10780616 DOI: 10.3390/nu16010145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/25/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024] Open
Abstract
(1) Background: Breast milk is the only source of nutrition for breastfed infants, but few studies have examined the relationship between breast milk micronutrients and infant neurodevelopmental outcome in exclusively breastfed infants. The aim of this study was to characterize the association between nicotinamide adenine dinucleotide (NAD)-related compounds in the breast milk of Japanese subjects and infant neurodevelopmental outcome. (2) Methods: A total of 150 mother-child pairs were randomly selected from the three-generation cohort of the Tohoku Medical Megabank in Japan. Infants were exclusively breastfed for up to 6 months. Breast milk was collected at 1 month postpartum, and the quantity of NAD-related substances in the breast milk was quantified. The mothers also completed developmental questionnaires at 6, 12, and 24 months. The relationship between the concentration of NAD-related substances in breast milk and developmental indicators was evaluated via ordinal logistic regression analysis. (3) Results: Nicotinamide mononucleotide (NMN) was quantified as the major NAD precursor in breast milk. The median amount of NMN in the breast milk was 9.2 μM. The NMN concentration in breast milk was the only NAD-related substance in breast milk that showed a significant positive correlation with neurodevelopmental outcome in infants at 24 months. (4) Conclusions: The results suggest that NMN in human milk may be an important nutrient for early childhood development.
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Affiliation(s)
- Yoshie Saito
- Wellness Science Labs, Meiji Holdings Co., Ltd., Hachioji 192-0919, Japan;
| | - Keigo Sato
- Food Microbiology and Function Research Laboratory, Meiji Co., Ltd., Hachioji 192-0919, Japan; (K.S.); (S.J.); (Y.N.)
| | - Shinji Jinno
- Food Microbiology and Function Research Laboratory, Meiji Co., Ltd., Hachioji 192-0919, Japan; (K.S.); (S.J.); (Y.N.)
| | - Yoshitaka Nakamura
- Food Microbiology and Function Research Laboratory, Meiji Co., Ltd., Hachioji 192-0919, Japan; (K.S.); (S.J.); (Y.N.)
| | - Takahiro Nobukuni
- Tohoku Medical Megabank Organization, Tohoku University, Sendai 980-8573, Japan; (T.N.); (S.O.); (S.M.); (S.K.); (S.K.); (K.O.)
| | - Soichi Ogishima
- Tohoku Medical Megabank Organization, Tohoku University, Sendai 980-8573, Japan; (T.N.); (S.O.); (S.M.); (S.K.); (S.K.); (K.O.)
- Graduate School of Medicine, Tohoku University, Sendai 980-8573, Japan
- Advanced Research Center for Innovations in Next-Generation Medicine, Tohoku University, Sendai 980-8573, Japan
| | - Satoshi Mizuno
- Tohoku Medical Megabank Organization, Tohoku University, Sendai 980-8573, Japan; (T.N.); (S.O.); (S.M.); (S.K.); (S.K.); (K.O.)
| | - Seizo Koshiba
- Tohoku Medical Megabank Organization, Tohoku University, Sendai 980-8573, Japan; (T.N.); (S.O.); (S.M.); (S.K.); (S.K.); (K.O.)
- Graduate School of Medicine, Tohoku University, Sendai 980-8573, Japan
- Advanced Research Center for Innovations in Next-Generation Medicine, Tohoku University, Sendai 980-8573, Japan
| | - Shinichi Kuriyama
- Tohoku Medical Megabank Organization, Tohoku University, Sendai 980-8573, Japan; (T.N.); (S.O.); (S.M.); (S.K.); (S.K.); (K.O.)
- Graduate School of Medicine, Tohoku University, Sendai 980-8573, Japan
- International Research Institute of Disaster Science, Tohoku University, Sendai 980-0845, Japan
| | - Kinuko Ohneda
- Tohoku Medical Megabank Organization, Tohoku University, Sendai 980-8573, Japan; (T.N.); (S.O.); (S.M.); (S.K.); (S.K.); (K.O.)
- Graduate School of Medicine, Tohoku University, Sendai 980-8573, Japan
| | - Masashi Morifuji
- Wellness Science Labs, Meiji Holdings Co., Ltd., Hachioji 192-0919, Japan;
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Repková A, Mišľanová C, Hrabčáková J, Masár M, Slezáková Z, Žemlička L, Valachovičová M. Relationship between Eating Habits and 4-Nonylphenol Concentration in Breast Milk of Women in Slovakia. Life (Basel) 2023; 13:2361. [PMID: 38137962 PMCID: PMC10744535 DOI: 10.3390/life13122361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/07/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023] Open
Abstract
4-Nonylphenol belongs to the alkylphenol group of chemicals, and its high occurrence in the environment can cause an adverse effect on human health. Breast milk can serve as a marker to take measure of human exposure to these chemicals through different routes of exposure. In this work, the influence of selected factors (the kind of water drank by the mothers; the consumption of fish, pork, and beef; wearing gloves; using nail polish, gel nails, vitamins, and medication) on the concentration on 4-nonylphenol in 89 breast milk samples was studied. The concentrations of nonylphenol in breast milk were determined by HPLC with fluorescence detection. The lowest and highest concentrations of 4-nonylphenol in breast milk were 0.97 ng/mL and 4.37 ng/mL, respectively. Statistical significance was observed for the consumption of pork (p = 0.048) and fish (0.041) in relation to the 4-nonylphenol concentration. Certain parameters (use of gel nails, beef consumption, and vitamin supplementation) were at the border of statistical significance (p = 0.06). Other parameters did not show any statistical significance. The results showed that breast milk in Slovakia does not contain a harmful dose of 4-nonylphenol and does not cause health problems. But it is necessary to continue this research and perform extended screening on a larger number of samples.
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Affiliation(s)
- Adriana Repková
- Department of Midwifery, Faculty of Nursing and Professional Health Studies, Slovak Medical University, 833 03 Bratislava, Slovakia; (A.R.); (J.H.)
| | - Csilla Mišľanová
- Institute of Nutrition, Faculty of Nursing and Professional Health Studies, Slovak Medical University, 833 03 Bratislava, Slovakia;
| | - Janka Hrabčáková
- Department of Midwifery, Faculty of Nursing and Professional Health Studies, Slovak Medical University, 833 03 Bratislava, Slovakia; (A.R.); (J.H.)
| | - Marián Masár
- Department of Analytical Chemistry, Faculty of Natural Sciences, Comenius University, 842 15 Bratislava, Slovakia;
| | - Zuzana Slezáková
- Department of Nursing, Faculty of Nursing and Professional Health Studies, Slovak Medical University, 833 03 Bratislava, Slovakia;
| | - Lukáš Žemlička
- Department of Nutrition and Food Quality Assessment, Institute of Food Science and Nutrition, Faculty of Chemical and Food Technology STU, 812 37 Bratislava, Slovakia;
| | - Martina Valachovičová
- Institute of Nutrition, Faculty of Nursing and Professional Health Studies, Slovak Medical University, 833 03 Bratislava, Slovakia;
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41
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Qin J, Zhou Y, Li H, Meng Y, Tanumihardjo SA, Liu J. A Correlation Study of Plasma and Breast Milk Retinol Concentrations in Breastfeeding Women in China. Nutrients 2023; 15:5085. [PMID: 38140344 PMCID: PMC10745653 DOI: 10.3390/nu15245085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/10/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
Retinol in breast milk is related to plasma concentration among breastfeeding women, but the linear or curvilinear relationships between the two remains unclear. We conducted a cross-sectional study in 403 Chinese breastfeeding women at 42 ± 7 days postpartum. Plasma and breast milk samples were assayed using high performance liquid chromatography to determine the concentration of retinol. Partial Spearman correlation and multivariable fractional polynomial regression were used to examine the relationships between the two retinol concentrations and between plasma retinol concentration and milk-to-plasma (M/P) retinol. The median (interquartile range, IQR) of the retinol concentration in the plasma was 1.39 (1.21, 1.63) μmol/L and 1.15 (0.83, 1.49) μmol/L in the breast milk, respectively. The partial correlation coefficient between them was 0.17 (p < 0.01). A linear relationship was observed with an adjusted regression coefficient of 0.34 (95% CI: 0.19, 0.49). The relationship between the plasma retinol and M/P ratio was nonlinear and segmented at 1.00 μmol/L of plasma retinol. The regression coefficients, below and above the segmented point, were -1.69 (95% CI: -2.75, -0.62) and -0.29 (95% CI: -0.42, -0.16), respectively. Plasma and breast milk retinol were positively correlated, whereas women with a low concentration of plasma retinol showed a stronger capacity of transferring retinol to breast milk.
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Affiliation(s)
- Jing Qin
- National Health Commission Key Laboratory of Reproductive Health/Institute of Reproductive and Child Health, Peking University Health Science Center, Beijing 100191, China; (J.Q.); (H.L.); (Y.M.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Yubo Zhou
- National Health Commission Key Laboratory of Reproductive Health/Institute of Reproductive and Child Health, Peking University Health Science Center, Beijing 100191, China; (J.Q.); (H.L.); (Y.M.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Hongtian Li
- National Health Commission Key Laboratory of Reproductive Health/Institute of Reproductive and Child Health, Peking University Health Science Center, Beijing 100191, China; (J.Q.); (H.L.); (Y.M.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Ying Meng
- National Health Commission Key Laboratory of Reproductive Health/Institute of Reproductive and Child Health, Peking University Health Science Center, Beijing 100191, China; (J.Q.); (H.L.); (Y.M.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Sherry A. Tanumihardjo
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA;
| | - Jianmeng Liu
- National Health Commission Key Laboratory of Reproductive Health/Institute of Reproductive and Child Health, Peking University Health Science Center, Beijing 100191, China; (J.Q.); (H.L.); (Y.M.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
- Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing 100191, China
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42
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Froń A, Orczyk-Pawiłowicz M. Understanding the Immunological Quality of Breast Milk in Maternal Overweight and Obesity. Nutrients 2023; 15:5016. [PMID: 38140275 PMCID: PMC10746120 DOI: 10.3390/nu15245016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 12/24/2023] Open
Abstract
Maternal obesity, affecting many pregnant women globally, not only poses immediate health risks but also modulates breast milk composition. Obesity is linked to inflammation and oxidative stress, impacting breast milk's immune properties. This paper explores the intricate relationship between maternal metabolic disorders, such as obesity, and breast milk's immunological components. We conducted a thorough search for original and review articles published until 17 October 2023 in the PUBMED/Scopus database. This search included several terms related to human breast milk, immunological properties, and obesity. Articles were selected with the consensus of all authors. Maternal metabolic disorders have discernible effects on the composition of immune-related components in breast milk, such as immunoglobulins, lactoferrin, leptin, ghrelin, adiponectin, C-reactive protein, growth factors, extracellular vesicles, and lymphocytes. These changes in breast milk composition can significantly impact the newborn's immune system, with potential long-term health implications beyond the immediate postnatal period. Maternal metabolic health is a critical factor in shaping the health trajectory of the neonate through breastfeeding, although the full advantages of breastfeeding for children of mothers with obesity remain uncertain. Ongoing research aims to understand and unravel these links.
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Affiliation(s)
- Anita Froń
- Division of Chemistry and Immunochemistry, Department of Biochemistry and Immunochemistry, Wroclaw Medical University, M. Skłodowskiej-Curie 48/50, 50-369 Wroclaw, Poland
| | - Magdalena Orczyk-Pawiłowicz
- Division of Chemistry and Immunochemistry, Department of Biochemistry and Immunochemistry, Wroclaw Medical University, M. Skłodowskiej-Curie 48/50, 50-369 Wroclaw, Poland
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43
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Aref HA, Salama I, Aboukhatwa SM, Helal MA, Kishk SM, Elgawish MS. Novel fluorescence approach for trace quantification of levonorgestrel in breast milk based on click reaction with benzonitrofurazan azide (NBD-AZ). Methods Appl Fluoresc 2023; 12:015009. [PMID: 37992321 DOI: 10.1088/2050-6120/ad0ee0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 11/16/2023] [Indexed: 11/24/2023]
Abstract
Although the great importance of oral contraceptive agents in birth control, their existence in breast milk became a cause for concern, since infant exposure to these hormones is associated with many health problems. Consequentially, developing a sensitive bioanalytical method for monitoring their concentrations in breast milk is an urgent demand to examine the safety or the risk of these compounds on infants. Levonorgestrel is one of the most common contraceptive hormones under concern. Despite the high sensitivity of the fluorometric methods, detection of Levonorgestrel by them is confined because its structure does not exhibit any fluorescence. For the first time, we proposed a promising click fluorescent probe, 4-azido-7-nitrobenzoxadiazole to react with the alkyne group of Levonorgestrel, to give a highly fluorescent triazole derivative that exhibited strong signal at wavelength of 544 nm after excitation at 470 nm. Reaction parameters impacting the fluorescence were cautiously studied and optimized. The suggested approach has been successfully applied in Levonorgestrel estimation in breast milk samples with linearity of (0.4-80 ng.ml-1) and low detection limit of 0.12 ng.ml-1without interferences from any biological components and with mean % recovery of 97.84 ± 2.73. Accuracy, sensitivity, selectivity, simplicity, and low-cost makes this approach a convincing, promising, and appealing alternative over reported analytical methods for Levonorgestrel bioanalysis in different matrices.
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Affiliation(s)
- Heba A Aref
- Medicinal Chemistry Department, Faculty of Pharmacy, El Mounufia University, El Mounufia ,32511, Egypt
| | - Ismail Salama
- Medicinal Chemistry Department, Faculty of Pharmacy, Suez Canal University, Ismailia, 41522, Egypt
| | | | - Mohamed A Helal
- Medicinal Chemistry Department, Faculty of Pharmacy, Suez Canal University, Ismailia, 41522, Egypt
- Biomedical Sciences Program, University of Science and Technology, Zewail City of Science and Technology, Giza, 12587, Egypt
| | - Safaa M Kishk
- Medicinal Chemistry Department, Faculty of Pharmacy, Suez Canal University, Ismailia, 41522, Egypt
| | - Mohamed Saleh Elgawish
- Medicinal Chemistry Department, Faculty of Pharmacy, Suez Canal University, Ismailia, 41522, Egypt
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44
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van der Schyff V, Kalina J, Abballe A, Iamiceli AL, Govarts E, Melymuk L. Has Regulatory Action Reduced Human Exposure to Flame Retardants? Environ Sci Technol 2023; 57:19106-19124. [PMID: 37992205 PMCID: PMC10702444 DOI: 10.1021/acs.est.3c02896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/10/2023] [Accepted: 09/29/2023] [Indexed: 11/24/2023]
Abstract
Flame retardant (FR) exposure has been linked to several environmental and human health effects. Because of this, the production and use of several FRs are regulated globally. We reviewed the available records of polybrominated diphenyl ethers (PBDEs) and hexabromocyclododecanes (HBCDDs) in human breast milk from literature to evaluate the efficacy of regulation to reduce the exposure of FRs to humans. Two-hundred and seven studies were used for analyses to determine the spatial and temporal trends of FR exposure. North America consistently had the highest concentrations of PBDEs, while Asia and Oceania dominated HBCDD exposure. BDE-49 and -99 indicated decreasing temporal trends in most regions. BDE-153, with a longer half-life than the aforementioned isomers, typically exhibited a plateau in breast milk levels. No conclusive trend could be established for HBCDD, and insufficient information was available to determine a temporal trend for BDE-209. Breakpoint analyses indicated a significant decrease in BDE-47 and -99 in Europe around the time that regulation has been implemented, suggesting a positive effect of regulation on FR exposure. However, very few studies have been conducted globally (specifically in North America) after 2013, during the time when the most recent regulations have been implemented. This meta-analysis provides insight into global trends in human exposure to PBDEs and HBCDD, but the remaining uncertainty highlights the need for ongoing evaluation and monitoring, even after a compound group is regulated.
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Affiliation(s)
| | - Jiří Kalina
- RECETOX,
Faculty of Science, Masaryk University, Kotlarska 2, 61137 Brno, Czech
Republic
| | - Annalisa Abballe
- Department
of Environment and Health, Italian National
Institute for Health, Viale Regina Elena 299, 00161 Rome, Italy
| | - Anna Laura Iamiceli
- Department
of Environment and Health, Italian National
Institute for Health, Viale Regina Elena 299, 00161 Rome, Italy
| | - Eva Govarts
- VITO
Health, Flemish Institute for Technological
Research (VITO), 2400 Mol, Belgium
| | - Lisa Melymuk
- RECETOX,
Faculty of Science, Masaryk University, Kotlarska 2, 61137 Brno, Czech
Republic
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45
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Albertos I, Romero J, Piqueras‐Picón A, García S, López M, Jiménez JM, Alija MJC. Market research of infant formula milks in Spain. Food Sci Nutr 2023; 11:7957-7966. [PMID: 38107113 PMCID: PMC10724587 DOI: 10.1002/fsn3.3712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 09/11/2023] [Accepted: 09/13/2023] [Indexed: 12/19/2023] Open
Abstract
There are circumstances in which breastfeeding is not possible and formula milk feeding has to be resorted to. In these cases, it is difficult to choose among the multitude of brands on the market for infant feeding. Although the composition of formula milk is largely regulated by legislation, there are certain nutrients whose presence in breast milk is beneficial. This circumstance will help us to establish some criteria to choose formula milk for a healthy infant. Among all the formula milks which can be found in different shops (pharmacies, supermarkets, etc.), market research has been carried out based on the nutritional criteria: the lipid and protein profile, certain carbohydrates, amino acids, and vitamins, as well as the presence of nucleotides, prebiotics, and probiotics. Based on these results, it can be established which formula milk we would give to a healthy infant. Thus, within the analyzed formula milks, it has been concluded that the most complete milk in this would be formula milk D and the least formula milk J. Although more studies are needed to confirm this, it is foreseeable that, as the scientific evidence is greater, the legislation will be updated and considering these nutrients for a correct formula milk.
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Affiliation(s)
- Irene Albertos
- Recognized Research Group: Assessment and Multidisciplinary Intervention in Health Care and Sustainable Lifestyles of the University of ValladolidValladolidSpain
| | - Janira Romero
- Recognized Research Group: Assessment and Multidisciplinary Intervention in Health Care and Sustainable Lifestyles of the University of ValladolidValladolidSpain
| | | | - Sara García
- Recognized Research Group: Assessment and Multidisciplinary Intervention in Health Care and Sustainable Lifestyles of the University of ValladolidValladolidSpain
| | - María López
- Recognized Research Group: Assessment and Multidisciplinary Intervention in Health Care and Sustainable Lifestyles of the University of ValladolidValladolidSpain
| | - José María Jiménez
- Recognized Research Group: Assessment and Multidisciplinary Intervention in Health Care and Sustainable Lifestyles of the University of ValladolidValladolidSpain
| | - María José Castro Alija
- Recognized Research Group: Assessment and Multidisciplinary Intervention in Health Care and Sustainable Lifestyles of the University of ValladolidValladolidSpain
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46
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Booker LA, Fitzgibbon C, Spong J, Deacon-Crouch M, Wilson DL, Skinner TC. Rapid Versus Slow Cooling Pasteurization of Donor Breast Milk: Does the Cooling Rate Effect Melatonin Reduction? Breastfeed Med 2023; 18:951-955. [PMID: 38100440 DOI: 10.1089/bfm.2023.0244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Background and Objective: There is a question as to whether melatonin levels in breast milk are impacted by the cooling rate postpasteurization. Past research that has used in the Australian donor bank's breast milk Holder Pasteurization technique has reported varying findings regarding melatonin levels postpasteurization. Where breast milk was cooled slowly, a significant reduction in breast milk melatonin levels was observed. Conversely, where a rapid cooling method was used, there was no significant reduction in melatonin levels. The aim of this study was to investigate whether the cooling process between the different pasteurization techniques impact on melatonin levels in breast milk postpasteurization. Materials and Methods: Twenty-seven nighttime breast milk samples were collected, with each sample divided into three; one remained unpasteurized, one was pasteurized and rapidly cooled to 4°C, and the other was pasteurized and cooled slowly to 4°C. Results: Melatonin levels were significantly reduced in both the rapidly cooled and slow cooled breast milk samples when compared to their unpasteurized counterpart (p < 0.001). There was no significant difference in melatonin levels between the two cooling methods (p = 0.91). Conclusion: This study showed that both the rapid and cooling pasteurization processes had a similar reduction in melatonin levels in breast milk. However, even after pasteurization melatonin was still present. Therefore, it is recommended that donor banks still take into consideration circadian timing hormones such as melatonin and the time of day breast milk is expressed.
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Affiliation(s)
- Lauren A Booker
- School of Psychology and Public Health, La Trobe University, Bendigo, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
| | - Cheree Fitzgibbon
- School of Psychology and Public Health, La Trobe University, Bendigo, Australia
| | - Jo Spong
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Melissa Deacon-Crouch
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Danielle L Wilson
- School of Psychology and Public Health, La Trobe University, Bendigo, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia
| | - Timothy C Skinner
- School of Psychology and Public Health, La Trobe University, Bendigo, Australia
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47
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Caba-Flores MD, Cardenas-Tueme M, Viveros-Contreras R, Martínez-Valenzuela C, Zurutuza-Lorméndez JI, Ortiz-López R, Cruz-Carrillo G, Neme Kuri JG, Huerta Morales D, Ponce Ramos S, Nava Bustos E, Camacho-Morales A. Preterm Delivery in Obese Mothers Predicts Tumor Necrosis Factor-α Levels in Breast Milk. Breastfeed Med 2023; 18:934-942. [PMID: 38100442 DOI: 10.1089/bfm.2023.0153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Background: Breast milk (BM) is a nutritive fluid that is rich in bioactive components such as hormones and cytokines that can shape the newborn's feeding habits and program the newborn's immature immune system. BM components can change under different scenarios that include maternal body mass index (BMI) and premature birth. This study aimed to study the interaction of premature status or maternal obesity on the hormonal and cytokine profile in BM according to the sex of the offspring. Materials and Methods: We recruited 31 women with preterm births from the Centro de Alta Especialidad Dr. Rafael Lucio in Mexico. Luminex multiplexing assay was used for quantifying cytokine profile of monocyte chemoattractant protein-1, tumor necrosis factor (TNF)-α, interferon-γ, interleukin (IL)1-β, IL-2, IL-4, IL-6, IL-7, and hormones insulin, ghrelin, leptin, and glucagon in mature BM samples. Biological modeling was performed to predict the interaction between cytokines and hormones, maternal BMI status, infant birth sex, parity, and gestational age. Results: BM multiplex analysis showed positive correlations for TNF-α and increasing prematurity and for higher maternal BMI and IL-2, IL-4, and IL-6 cytokines. Multiple regression models identified an interaction between maternal BMI and gestational weeks in male infants that is associated to TNF-α accumulation in BM. Biological modeling predicts that preterm delivery in mothers with obesity modulates TNF- α levels in mature BM of women with male offspring. Conclusion: Prematurity and obesity modify BM's immune profile. TNF- α expression increases as prematurity increases, and maternal BMI correlates positively with increases in IL-2, IL-6, and IL-4. Our multiple regression model also shows that maternal BMI and gestational weeks in male infants predict TNF-α.
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Affiliation(s)
- Mario Daniel Caba-Flores
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
- Unidad de Neurometabolismo, Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Nuevo León, México
| | - Marcela Cardenas-Tueme
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud and The Institute for Obesity Research, Monterrey, Nuevo León, México
- Centro de Investigación en Nutrición y Salud Pública, Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | | | - Carmen Martínez-Valenzuela
- Unidad de Investigación en Ambiente y Salud, Universidad Autónoma de Occidente, Los Mochis, Sinaloa, México
| | - Jorge Iván Zurutuza-Lorméndez
- Centro de Investigaciones Biomédicas, Universidad Veracruzana, Xalapa, Veracruz, México
- Doctorado en Ciencias Biomédicas, Centro de Investigaciones Biomédicas, Universidad Veracruzana, Xalapa, Veracruz, México
| | - Roció Ortiz-López
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud and The Institute for Obesity Research, Monterrey, Nuevo León, México
| | - Gabriela Cruz-Carrillo
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
- Unidad de Neurometabolismo, Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Nuevo León, México
| | - Juan Gerardo Neme Kuri
- Subdirección de enseñanza, Centro de Alta Especialidad Dr. Rafael Lucio, Xalapa, Veracruz, México
| | - David Huerta Morales
- Departamento de Pediatría, Centro de Alta Especialidad Dr. Rafael Lucio, Xalapa, Veracruz, México
| | - Samantha Ponce Ramos
- Departamento de Pediatría, Centro de Alta Especialidad Dr. Rafael Lucio, Xalapa, Veracruz, México
| | - Edith Nava Bustos
- Coordinación Hospital Amigo del Niño y de la Niña, Centro de Alta Especialidad Dr. Rafael Lucio, Xalapa, Veracruz, México
| | - Alberto Camacho-Morales
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
- Unidad de Neurometabolismo, Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Nuevo León, México
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48
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Garon-Carrier G, Tiraboschi GA, Bernard JY, Matte-Gagné C, Laurent A, Lemieux A, Fitzpatrick C. Unraveling the effects of maternal breastfeeding duration and exclusive breast milk on children's cognitive abilities in early childhood. Front Public Health 2023; 11:1225719. [PMID: 38106907 PMCID: PMC10722166 DOI: 10.3389/fpubh.2023.1225719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 11/14/2023] [Indexed: 12/19/2023] Open
Abstract
Background This study investigated the putative associations between mothers' use of exclusive breast milk and the duration of breastfeeding with child cognitive development. Methods This study is based on 2,210 Canadian families with children assessed longitudinally from age 4 to 7 years on their memory-span and math skills. These cognitive abilities were measured with standardized tasks. Breastfeeding practices were collected via maternal reports. We applied propensity scores to control the social selection bias for breastfeeding. Results Results adjusted for propensity scores and sample weight revealed no significant differences between non-breastfed children with those being non-exclusively breastfed for 5 months or less, and with children being exclusively breastfed for 9.2 months on average, on their early math skills and memory-span. We found that children who were non-exclusively breastfed for 6.8 months on average had a slightly higher levels of memory-span at age 4 than children who were never breastfed, and this small but significant difference lasted up to age 7. Conclusion Our findings suggest no significant differences between children being exclusively breastfed and those fed with formula on their early math skills and memory-span. The encouragement of breastfeeding to promote child cognitive school readiness may, in some case (non-exclusive breastfeeding for more than 5 months), show a small but long-lasting advantage in early memory-span.
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Affiliation(s)
| | - Gabriel Arantes Tiraboschi
- Département de Psychoéducation, Université de Sherbrooke, Sherbrooke, QC, Canada
- Département d’enseignement au préscolaire et primaire, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Jonathan Y. Bernard
- Inserm, INRAE, Centre for Research in Epidemiology and Statistics (CRESS)Université Paris Cité and Université Sorbonne Paris Nord, Paris, France
| | | | - Angélique Laurent
- Département d’enseignement au préscolaire et primaire, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Annie Lemieux
- Département de Psychoéducation, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Caroline Fitzpatrick
- Département d’enseignement au préscolaire et primaire, Université de Sherbrooke, Sherbrooke, QC, Canada
- Department of childhood education, University of Johannesburg, Johannesburg, South Africa
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49
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Suteerojntrakool O, Mekangkul E, Ananta P, Maitreechit D, Khabuan S, Sodsai P, Hirankarn N, Thumbovorn R, Chomtho S. The Persistence of Specific Immunoglobulin A Against SARS-CoV-2 in Human Milk After Maternal COVID-19 Vaccination. Breastfeed Med 2023; 18:943-950. [PMID: 38100444 DOI: 10.1089/bfm.2023.0210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Objectives: To investigate SARS-CoV-2 specific immunoglobulin A (sIgA) in breast milk of Thai mothers post COVID-19 vaccination and/or SARS-CoV-2 infection, and to compare the sIgA among lactating mothers with varying COVID-19 vaccination regimes. Materials and Methods: A longitudinal study was conducted in lactating mothers receiving ≥2 doses of COVID-19 vaccine or confirming SARS-CoV-2-positive test as a part of an infant feeding survey. Vaccination and infection details were collected through questionnaires and interviews. Self-collected breast milk samples (30 mL) at 1, 3, and 6 months postvaccination or infection were analyzed for sIgA through enzyme-linked immunosorbent assay (ELISA). Results: Eighty-eight lactating mothers (152 milk samples), average age of 30.7 ± 6.2 years, were recruited. Fifty-five percent of milk samples were from lactating mothers with both SARS-CoV-2 infection and vaccination (hybrid immunity); 40% were from those with vaccination alone (COVID naïve). Sixty percent of lactating mothers received mixed types of vaccines. Median sIgA ratio in breast milk was 2.67 (0.82-7.85). Breast milk sIgA at 1, 3, and 6 months were higher in mothers with hybrid immunity than in COVID naïve (geometric mean [95% confidence interval]: 3.30 [2.06-5.29] versus 1.04 [0.52-2.04], 3.39 [2.24-5.13] versus 1.26 [0.77-2.06], 4.29 [3.04-6.06] versus 1.33 [0.74-2.42], respectively). No significant differences were observed among various vaccination regimes. Conclusion: sIgA against SARS-CoV-2 was detected in breast milk for up to 6 months after immunization together with infection at a greater level than after immunization or infection alone. This immunity could be transferred and protective against SARS-CoV-2 infection. Discontinuation of breastfeeding among mothers who received COVID vaccination or experienced infection should be discouraged. Clinical Trial Registration number: TCTR20220215012.
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Affiliation(s)
- Orapa Suteerojntrakool
- Pediatric Nutrition Research Unit, Division of Nutrition, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Ambulatory Division, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Eakkarin Mekangkul
- Pediatric Nutrition Research Unit, Division of Nutrition, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Division of Nutrition, Department of Pediatrics, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
| | - Pattaraporn Ananta
- Division of Nutrition, Department of Pediatrics, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
| | | | - Siriporn Khabuan
- Pediatric Nutrition Research Unit, Division of Nutrition, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Pimpayao Sodsai
- Center of Excellence in Immunology and Immune-Mediated Diseases, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nattiya Hirankarn
- Center of Excellence in Immunology and Immune-Mediated Diseases, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Rungtip Thumbovorn
- Department of Microbiology, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
| | - Sirinuch Chomtho
- Pediatric Nutrition Research Unit, Division of Nutrition, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Lazenby GB, Sundstrom B, Momplaisir FM, Badell ML, Rahangdale L, Nissim OR, Tarleton JL, Dempsey AR. Attitudes on breast feeding among persons with HIV who have given birth and their perceptions of coercion during counseling on safe infant feeding practices. AIDS Care 2023; 35:1852-1862. [PMID: 36435965 PMCID: PMC10213150 DOI: 10.1080/09540121.2022.2147481] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 11/08/2022] [Indexed: 11/28/2022]
Abstract
Persons with HIV can receive mixed messages about the safety of breastfeeding. We sought to assess if they felt coerced to formula feed when counseled about practices to reduce HIV transmission. Persons with HIV who had given birth were eligible to complete a survey to describe their experiences with infant feeding counseling and if they felt coerced to formula feed. An Iowa Infant Feeding Attitude Scale (IIFAS) assessed attitudes towards breastfeeding. Qualitative analyses were performed on narrative responses. One hundred surveys were collected from sites in Georgia, North Carolina, Pennsylvania, and South Carolina. The mean IIFAS score (n, 85) was 47 (SD 9.2), suggesting relatively favorable attitudes toward breastfeeding. Thirteen persons reported feeling coerced to formula feed. When controlling for choosing to give any breast milk, persons with any college education were more likely to report feeling coerced (aOR 9.8 [95% CI 1.8-52.5]). Qualitative analyses revealed three themes: perceiving breastfeeding as unsafe, engaging in shared decision-making, and resisting advice to formula feed. Persons with HIV desire to be counseled about safe infant feeding practices and have their questions answered without judgement. We highlight experiences of persons with HIV that reflect a need for a nuanced approach to infant feeding counseling.
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Affiliation(s)
- Gweneth B Lazenby
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA
| | - Beth Sundstrom
- Department of Communication, College of Charleston, Charleston, SC, USA
| | - Florence M Momplaisir
- Department of Medicine, Division of Infectious Diseases, University of Pennsylvania, Philadelphia, PA, USA
| | - Martina L Badell
- Department of Obstetrics of Gynecology, Emory University, Atlanta, GA, USA
| | - Lisa Rahangdale
- Department of Obstetrics of Gynecology, University of North Carolina, Chapel Hill, NC, USA
| | - Oriel R Nissim
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA
| | - Jessica L Tarleton
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA
| | - Angela R Dempsey
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA
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